Study On High Medical Expenditure And Influencing Factors Of 1763 Cases In A 3 A Hospital

Object: The aim of this study is to describe feature and influencing factor of the high medical expenditure in a 3A hospital . This study explores the major reason of the high medical expenditure; and the deep reason from the area in hospital, which can decrease the waste of the health resources ; should be established and medical practice standardized, in order to ensure the quality of medical service. And this study can provide a reason to rational development and utilization of health resources; cutting down the cost of production.Methods: A retrospective study of outpatient whose medical expenditure was above 50000 yuan from a 3A hospital during the period of 2004 to 2006 were conducted. All of the case was 1763.Through studying interview the doctor , nurse and administrative personnel we could know the influencing factor of the high medical expenditure. Through conducting the study in a random sample of 150 cases we could know the something about the using of the drugs .Analyses were carried out descriptive analysis and using SPSS 11.0 software package.Results: The volume of the patient of the high medical expenditure had been increasing each year. Those had a notable impact on the high medical expenditure, which were complications, the patient's condition being critical,male,death and hospital day. We could see 51% patients use the application of high-tech achievements. Percentage of encounters with an antibiotic was 87.4% and Percentage of encounters with an antibiotic for guarding against infection was 59.93%.We could see the percentage of cost of drugs and health materials were 37.56% and 31.53%.And the patient's being critical and safe medical are the influencing factors of the high medical expenditure.Conclusion: The study shows that influencing factors of the high medical expenditure in a 3A hospital which are the high cost of drugs and health materials; the application of high-tech achievements ;the patient's condition being critical and safe medical; the hospital and the doctor lacking of patient cost restraint; the things that the patient are unsafe; long hospital day and overtreatment. We should control the long hospital days and strengthen the management of drugs and high price health materials .We should strengthen the management of high-tech achievements.