Research On Hospitalization Expenditure And Its Influential Factors In A County Level Hospital In Dalian

Objectives: Using hospitalized cost data of a county-level hospitals in Dalian in2011tounderstand the distribution of hospitalization expense and study the influential factors ofhospitalization expenses, for reasonable and effective utilization of health resources, andprovide evidence for the excessively rapid increasing of the medical expense controlmeasures.Methods: From a hospital information system at the county level in Dalian in2011hospitalized patients with medical expenses as the object of this study and theinformation, the research content including patient hospitalization expenses andexpenses in the composition of the situation and the influential factors of hospitalizationexpenses. Total hospitalization expense of descriptive statistics using arithmetic mean,median, standard deviation, and interquartile spacing. The composition of thehospitalization expense by constituent ratio and percentage bar graph is described. Thedifference between the two groups compare the Mann-Whitney U test, comparisonbetween multiple sets of use Kruskal Wallis H-inspection. With total cost, expenses formedicine, treatment, examination of values for the dependent variable for multiplelinear regression model, at the same time on single diseases such as coronary heartdisease, malignant tumor, cerebral thrombus to establish multiple linear regressionmodel to analyze the influence factors of hospitalization expenses. All statisticalanalysis using SPSS16.0software package, two-sided hypothesis test standards as theα=0.05.Results: Eliminate information incomplete, a total of20540inpatient hospitalizationcost data included in the statistical analysis of the present study. The hospital totalhospitalization expenses of hospitalized patients with2011median is4819.23Yuan,expenses for medicine, examination, treatment time were the median is2218.03Yuan,526.75Yuan and429.59Yuan respectively, its proportion in the total hospitalizationmedical expenses were43.76%,15.84%and12.42%respectively. Hospital form than the top five diseases respectively for coronary heart disease (1872cases, constitute morethan34.96%), malignant tumor (1354cases, constitute more than25.29%), cerebralthrombosis (941cases, constitute more than8.79%), fractures (690cases, constitutemore than12.89%), diabetes (497cases, constitute more than9.28%). Male patientswere total hospitalization expense (4917.63Yuan) and women (4759.13Yuan)difference was statistically significant (Z=2.560, p=0.001), were hospitalized Medicarepatients time cost (7528.73Yuan) higher than the self-paid patients (6084.73Yuan, Z=19.833, p=0.000), time surgery patients are hospitalized fee (6050.73Yuan) issignificantly higher than non-surgical patients (4240.73Yuan, Z=34.82, p=0.000), thesecond all total hospitalization cost between the various departments (1696.33Yuan to693.93Yuan, X2=1696.33, p=0.000), and in between (4605.83Yuan to5000.93Yuan,X2=4605.83, p=0.047), between the age groups (3636.03Yuan to5507.63Yuan, X2=3636.03, p=0.000). In multiple linear regression model, the total medical expenses inhospital number of days (b=0.627), whether or not surgery (b=0.224), the paymentmethod (b=0.153), age (b=0.114), gender (b=0.038) into equation; In multivariatelinear regression model for medicine and hospitalization days (b=0.626), the paymentmethod (b=0.371), department (b=0.150), whether or not surgery (b=0.017) intoequation; In the treatment of multiple linear regression model, the hospitalization days(b=0.453), whether or not surgery (b=0.412), gender (b=0.079), department (b=0.057), the payment method (b=0.044), age (b=0.028) into equation; In theexamination of the multiple linear regression model, whether surgery (b=0.259),hospitalization days (b=0.237), the payment method (b=0.219), gender (b=0.207),age (b=0.036) into the equation. In coronary heart disease, malignant tumor, cerebralthrombus total hospitalization expense of multivariate linear regression model of singlediseases of hospitalization days, whether surgical, payment method is the maininfluence factors.Conclusion:1.For medicine, inspection fee, fee on the total hospitalization costsconstitute a larger proportion than,43.76%,15.84%and12.42%, respectively, to controlthe excessive growth of medical costs, must be strictly controlled high drug prices andthe use of inspection equipment.2. Age is the main influential factors of hospitalizationexpenses. Characteristics due to the aging population, leading to rising health care costs,in the face of our country has entered the aging society, must do a good job in healthcare for older people to reduce medical costs.3. Payment method is one of the important factors affecting medical expenses, deepening the reform of medical insurance system,to control because of "the third party pay" the waste of medical resources.4.Surgery isanother important factor to the growth of hospitalization expenses, the hospital shouldstrengthen the medical quality management, reduce the risk of postoperative infection,and avoid unnecessary surgery, control the use of advanced surgical equipment.5.Hospitalization expense grows along with the increase of hospitalization days, therefore,shorten patients’ hospitalization days and improve bed turns, so that we can achieve thepurpose of effectively reduce the hospitalization expenses.6.Hospitalization days,payment method, whether surgery is coronary heart disease, malignant tumor, cerebralthrombosis, main influencing factors of hospitalization expenses.