A Comparative Study On Hospitalization Health Expenditure Between Surgery Patients With Different Types Of Admissions In Some Three-level Hostipal

With the development of China’s economy and the improvement of the health needs of the public,Corresponding health expenditures and medical costs are also increasing. The rapid growth of medical costs has been widely concerned by public.Because of the combined effects of various factors, including hospitalization expenditures, medical expenditures, the trend of costsincreasing is difficult to change in a short time. As an important part of the hospital service, operation consumes a lot of health resources and has a huge operation expenditures. China has already become the countrywhich has largest number of surgery in the world, which requires us to reduce the cost of medical supplies and cancel the addition of drugs, at the same time, reasonably control the price of medical treatment, surgery and other services.In the past, most of the related researches on the expenditures of hospitalization started with single disease and payment methods to control costs in China. But they paid less attention to the impact of operating unit and differentadmission modes on the costs of hospitalization. Therefore, exploring operation and the relationship between emergency operation, selective operation and the expenditures of hospitalizationis of great significance to effectively control the excessive rise in hospitalizationexpenditures and improve the related research on hospitalization expenditures.Research Objectives:To explore the main composition of hospitalization expenditures and operationexpenditures, and the relationship between emergency operation, selective operation and the expenditures of hospitalization by analyzingpatient number, expenditures constitution and different expenditures of hospitalization on different admission modesof a grade A tertiary hospital from 2011 to 2015 in Shandong Province. Provide a new way to lower the expenditures of hospitalization and reduce the burden of patients effectively.Research Methods:This researchadopted the investigation method of reviewing the medical records.lt imported SPSS21.0for database sorting, data preprocessing and data analysisafter screening the Excel electronic medical record database. Statistically analyzetotal patients in hospital, single disease, the distribution ofpatients in single department, expenditures constitution and influencing factors by two independent samples of non parametric test, mean number comparison, analysis of relationship and other methods.Main Results:1. General InformationAmong all surgical patients in the hospital from 2011 to 2015, the number of women was more than that of men. Specifically, there were 93151 cases for female and 68078 cases for male, accounting for 57.8% and 42.2% respectively. The age distribution of the patients in the study changed around the maximum number of 40 years old. With the growth of the age, the number of surgery patients showed a rise-fall trend. As for the way of payment, the proportion of patients in the insurance system accounted for 56.9%of the total(urban Residents basic medical insurance system,urban Employees basic medical insurance system,new rural cooperativeinsurance syste), doublingthat of patients at their own expenditures.According to the departmentdistribution, the number of patients in obstetrical department and general surgery department was more than 10% respectively. In the distribution of patients of differentadmission modes, the number of selective operation cases was 142224, accounting for 88.2% of the total number, while the number of emergency operation cases was 19005, accounting for 11.8% of the total number.2. The distribution of patients with single disease and the impact of different admission modes on the expenditures of hospitalizationThe health service charges structure of heart disease in admission modes is basically the same. The average expenditures for emergency operation was 74689.1 yuan, and 62969.2 yuan for selective operation. According to a non-parametric test for two independent samples, P<0.001, there were significant differences in the total cost distribution of two groups. The total cost of emergency operation is higher than that of selective operation.3. Effect of different sections of the distribution of patients and expenditures of hospitalization for hospitalization wayThe age distribution of the patients was 40 years old, and the first increased and then decreased. In the surgical patients in hospital expenditures, the highest proportion of health materials costs, and showed an increasing trend year by year. There was an upward trend in the average cost of patients undergoing elective operation and emergency operation. The study confirmed that the different ways of hospitalization of single disease patients have a significant impact on the expenditures of hospitalization.In comparison to internal department, pediatrics, hand and foot surgery, ophthalmology, cardiac surgery, emergency surgery emergency, patients undergoing elective total cost also exist significant differences, emergency surgery in patients with total cost higher than patients undergoing elective surgery.Conclusion:The study was based on the six sections which proportion of emergency patients are more than 10% of total patients.To explore the relationship of hospitalization expenditures and operationexpenditures, according to a non-parametric test for two independent samples,Pediatric, hand and foot surgery, Department of Ophthalmology, cardiac surgery, emergency surgery,there were significant differences in the total cost distribution of two groups.The total expenditures of selective operation is higher than that of emergency operation.The hospitalization expenditureshas larger gap between the departments, the highest department is cardiac surgery, it has up to 103889.6 yuan, and the obstetrics is lowest part--8101.1 yuan. The age distribution of cardiac surgery patients is olderin age,Pediatric patients are generally younger than others, obstetrics focused on 20-40 years old age. From the point of view of payment, the obstetrics departmentproportion of self paid at their own expenditures is much higher than other departments. The proportion of farmers in Cardiac surgery, Department of Ophthalmologyfarmers are more than 50% in occupational distribution,Policy recommendations:1. To strengthen the health and Economic Research of the operation service package, to improve the evaluation of the effectiveness of the operation project,to reduce the use of inefficient consumable materials and the development of the project of low efficiency. To provide individualized surgical treatment services for patients with surgery, increase the patients’ selectivity, enhance the cognitive level of the operation expenditures of patients, reduce the possible misunderstanding in the process of diagnosis and treatment.2. To improve medical dispute handling procedures, establish and perfect the system of standardized diagnosis and treatment process, effectively protect the rights and interests of medical workers, reduce the potential of "self protection treatment, reduce unnecessary medical expenditures.3.Treatment of disease should adhere to the "early detection, early diagnosis, early treatment". Taking heart disease as an example, Not only the relevant literature shows that the clinical effect of elective surgery is significantly better than the emergency operation,but also the study found that elective surgery is also significantly lower than the expenditures of emergency surgery. Therefore, to strengthen the popularity of health knowledge, and actively promote the "early detection, early diagnosis, early treatment" of the health concept, the control of medical costs is still significant.