Study Of Calculation And Control Measures Of Expenses Of Case Mix In Senile Cataract

The excessive growth of medical expenses has placed a heavy financial burden to the country, units and individuals. It also constrains the development of the health cause. To availably control the medical treatment expenses soars, in 1982 the United States first practiced the related classification in diagnosis method (DRGs) with the pre-arranged sum payment system and achieved so much.DRGs was introduced into our country in the early 1990s and the feasibility study was conducted at the same time. The researches have shown that it is necessary and feasible to conduct the study on Case Mix. It is necessary to study the practicality of Case Mix in medical insurance reimbursement and further reform of the military health expenditure. From domestic and international experience, DRGs has to be developed to suit our national and area situations.Therefore, to research an effective combination of hospitalized cases is an important part of medical insurance reimbursement and reform of military health expenditure. It is necessary means to achieve macro-and micro-medical costs and medical quality management, and an urgent need of the current medical insurance system reform.This research selected Senile cataract as study object, for it is common, easily diagnosed and clear clinical treatment programs. We analyzed its basic situation, medical expenses and the main influential factors of medical costs. We processed cases combination by AID, and got the standard reference value of the cases combinations of cataract. Meanwhile, we studied the control measures of medical costs.The expenses of surgery and drugs are the main components of the medical costs, accounting for 83.70% of total costs. Based on the univariate andmultivariate analyses of the factors that affect medical costs, we selected diagnosis, identity and age as classification nodes. Cataract patients were divided into 4 packages, the costs of standard reference value were then calculated.We monitored the key links that affect the medical cost by developing information system of the management of single disease cost, and tried to apply the clinical pathways into the hospitalizaton management of the senile cataract.