Objective: To explore the impacts of the multidisciplinary team model on the average length of stay and hospital expenses of patients with lung cancer.
Methods: After the multidisciplinary team discussion, 97 patients with lung cancer were selected as the lung cancer group according to the enrollment and elimination criteria the control group was 97 patients with lung cancer managed without team discussion during the same period. All the patients were firstly diagnosed to have lung cancer from December 2011 to December 2013 in Subei People's Hospital. The length of stay, hospital expenses, stages of tumor, types of tumor, Zubrod-ECOG-WHO score, the form of payment, smoking history, sex and age of all the patients were collected. The difference in the average length of stay and hospital expenses between the 2 groups and the associated factors were analyzed by using χ² test, t test and multi-factor stepwise regression analysis.
Results: There were 68 males and 29 females with a mean age of (61 ± 9) years in the lung cancer group, while there were 73 males and 24 females with a mean age of (63 ± 10) years in the control group. There were no differences between the 2 groups in tumor staging, tumor types, Zubrod-ECOG-WHO score, the form of payment, smoking history, sex and age (χ² = 4.854, P = 0.563, χ² = 4.248, P = 0.097; χ² = 0.395, P = 0.821; χ² = 1.191, P = 0.554; χ² = 0.108, P = 0.977; χ² = 1.011, P = 0.389; χ² = 0.649, P = 0.519; P = 0.474, P = 0.845, respectively). The average hospital expenses (13 303 vs 16 553, Yuan) were lower and the length of stay (10.33 vs 12.49, days) was shorter in the lung cancer group as compared to the control group (t = 2.616, P = 0.010; t = 2.730, P = 0.007), especially so for the first clinical hospitalization (15 953 vs 19 485 yuan, t = 2.315, P = 0.022; 12.71 vs 14.75 days, t = 1.979, P = 0.049). The average length of stay and the tumor stages were the main factors associated with the average hospital expenses. Except for patients with the limited stage of small cell lung cancer, the average length of stay and hospital expenses showed a tendency to reduce in different stages of the lung cancer group. The hospital cost was lower and the length of stay shorter for patients with stages Ia-IIIa and IIIb-IV in the lung cancer group as compared to the control group (6 722 vs 8 188 yuan; 1.09 vs 2.65 days).
Conclusions: The multidisciplinary team model was an effective measure to cut down the hospital expenses and shorten the length of stay of lung cancer patients, especially for the first hospitalization. Patients may benefit from the multidisciplinary team approach according to their stages. On the basis of reducing the hospital costs and the length of stay, it further reduced the gap of the length of stay and hospital expenses between patients with Ia-IIIa and IIIb-IV diseases, while patients with stage Ia-IIIa disease seemed to benefit more.