Study On Hospital Expenditure And The Influence Factors Of COPD Patients In Lanzhou City Hospital

Objective To investigate the cost of hospitalization for Chronic Obstructive Pulmonary Diseases(COPD)patients in Lanzhou city from 2013 to 2016,and to use the grey correlation analysis to analyze the correlation of the internal structure of hospitalization expenses among patients discharged from COPD and from patients with COPD.The sociological characteristics and clinical features of population were studied.The recurrence system model was used to explore the influencing factors of the patient’s hospitalization cost.Starting from the key influencing factors,the structural equation model was used to further analyze the impact of key influencing factors on different hospitalization cost items,the level of effects between various of influenced factors is more clearly.This article provides scientific and rational decision-making and reference for the relevant departments to effectively control the excessive growth of hospitalization costs,prevent the increase of COPD attack rate year by year,integrate health resources,improve the quality of medical services and the utilization of health resources.Methods The data comes from the Gansu Province Health and Family Planning Statistical Information Network Direct Report System.Through screening and screening COPD patients in Lanzhou City during 2013-2016,18,142 cases were obtained.In the basic descriptive analysis of patient hospitalization costs,continuous variables were analyzed using mean,median,standard deviation,and quartile analysis,and categorical variables were expressed as constituent ratios(rates).Since the hospitalization costs and hospitalization days did not obey the normal distribution,a non-parametric rank sum test was used.Using 2016 as the base year,hospitalization fees and various expenses in other years were discounted using the health care consumer price index(CPI).The degree of association between the various expenses in the hospitalization and the total expenses was analyzed using the grey correlation analysis.SPSS22.0 was used for single factor analysis,correlation analysis and recursive system model analysis,and AMOS23.0 was used for structural equation model analysis.Test level α=0.05.Results The number of COPD patients in Lanzhou increased year by year from 2013 to 2016,and the number of male patients was significantly higher than that of female patients;the number of patients in the 70-89 age group was the highest;the average hospitalization cost from 2014 to 2015 showed an upward trend but a small increase.Compared with 2015,2016,the average cost per year has decreased;gray correlation shows the cost of hospitalization for patients with COPD.The degree of relevance is drug,diagnosis,other expenses,treatment fees,and medical material costs.The differences in the composition of hospitalization expenses are not significant;the univariate analysis and recursive system model show that the overall effect of each factor on the hospitalization costs of patients is,in descending order,the grade of the hospital,the number of days of hospitalization,whether the operation,occupation,route of admission,diagnosis of compliance,The medical payment method,gender,admission condition,age,number of hospitalizations,and drug allergy were 12 factors,and marital status,presence or absence of comorbidities,and complications were excluded by the equation(P>0.05).From the structural equation model,it was found that the total effect of each exogenous variable on the number of days of hospitalization,drug costs,diagnosis fees,and general medical service fees was basically consistent with the recursive system model.Conclusions 1.In 2013-2016,the hospitalization cost of COPD patients in Lanzhou was 8,134.11 yuan,and the median value was 6794.52 yuan.The patient’s economic burden of disease was excessive.2.The main concern groups that reduce the burden of COPD are men,retirees,patients aged 70-89 years.3.Among the hospitalization expenses of the patients,the proportion of drug costs in the total expenses was the highest(42.65%),followed by the diagnosis fee(27.32%),the hospitalization fee was unreasonable,the drug and diagnostic costs were reduced,and the labor value of medical personnel was increased.Key points for effective control of hospitalization costs.4.The main effects of hospitalization costs are as follows: whether the tertiary hospital,the number of hospital stays,whether the surgery,and occupation are “retirees”.The recursive system model clearly shows the complex hierarchical relationships among the factors.From the structural equation model,it is found that these factors have direct or indirect effects on drug costs,diagnosis fees,and general medical service fees.Model fitting results are good,in line with the actual situation and the explanation is reasonable.It is necessary to proceed from the above major influencing factors and adopt more favorable ones.Cost control measures to reduce hospitalization costs in COPD patients in Lanzhou City.