Analysis Of Hospitalization Expenses And Influencing Factors Of Hepatitis B-related Diseases In A City Of Guangxi

ObjectiveGuangxi is an area with a high incidence of hepatitis B.The data in medical records on first page of inpatients with hepatitis B-related diseases from2017 to 2019 in a city of Guangxi was analyzed and studied to explore the factors affecting the hospitalization expenses of patients with hepatitis B-related diseases,so as to provide scientific and reasonable basis and reference for relevant departments,and further formulate health policies and control the excessive growth of hospitalization expenses,effectively prevent the spread of hepatitis B disease,optimize the allocation of health resources,and ensure patients’basic medical and health services.MethodsThe data analyzed in this study came from medical records on first page of inpatients with hepatitis B-related diseases in 42 hospitals in Guangxi.Through screening the original sample data,a total of 4,639 cases were included.The social-demographic characteristics,hospitalization information,clinical characteristics and individual expenses information of patients were extracted from their medical records.These variables were statistically described by software SPSS25.0.The hospitalization expenses of patients were analyzed by single factor analysis and multiple linear regression analysis.The statistical analysis indicators included constituent ratio,ratio,mean,standard error,range,median and quartile and so on.Finally,structural equation model analysis was carried out by software AMOS26.0,and the effects of various variables on hospitalization expenses were obtained.Because the hospitalization expenses did not obey the normal distribution,the nonparametric test was used to include the natural logarithm of the hospitalization expense in multiple linear regression analysis and structural equation model analysis.The significant level in all statistical analysis was set to beα=0.05.Results1.The results of the analysis of hospitalization expenses of patients with hepatitis B-related diseases showed that the average hospitalization expense of patients with hepatitis B-related diseases was 15,388.52 yuan per case.Among them,the average hospitalization expenses of patients with chronic hepatitis B,acute hepatitis B,liver cirrhosis and primary liver cancer were 8,950.18 yuan,8,881.60 yuan,13,857.55 yuan and 37,088.77 yuan respectively.The top three individual expenses that constitute the hospitalization expenses of patients were western medicine（30.46%）,diagnosis fee（22.13%）and medical consumables（13.84%）.2.The results of the analysis of patients’medical payment showed that74.64%of the patients paid by medical insurance,the average hospitalization expense was 15,725.85 yuan per case,and the median hospitalization expense was 8,346.79 yuan,and most of the patients paid by basic medical insurance for urban residents.The average hospitalization expense of patients without medical insurance was 14,384.91 yuan per case,and the median hospitalization expense was 8,981.78 yuan.3.Univariate analysis showed that patients’gender,age,occupation,marriage,medical payment method,hospital grade,hospital stay,admission route,admission condition,complication,drug allergy,operation and other factors had statistically significant influence on hospitalization expense.Univariate analysis of patients’ethnic group showed P>0.05,so it can be considered that the influence of ethnic group on hospitalization expenses was not statistically significant.4.The results of multiple linear regression analysis showed that the influencing factors on hospitalization expenses were in the following order:hospital stay,operation,age,drug allergy,occupation,gender,admission condition,admission route and medical payment method.The multiple linear regression equation can be expressed as:Y=8.504-0.144X₁+0.01X₂-0.031X₃+0.056X₅-0.028X₇+0.074X₈+0.051X₉+0.223X₁₀-0.731X_11.The variables such as marriage,hospital grade and complications were not included in the equation（P>0.05）.The results of structural equation model analysis were basically consistent with those of multiple linear regression analysis.Conclusion1.The direct medical economic burden of patients with hepatitis B-related diseases in Guangxi is too heavy,and with the deterioration and development of the disease,the burden of patients becomes heavier and heavier.Moreover,the composition of hospitalization expenses of patients is unreasonable,and western medicine is the main factor affecting the unreasonable increase of hospitalization expenses.2.There are still many patients without paid by medical insurance,but the average hospitalization expense of patients who pay by medical insurance is higher.3.There are many variables that affect patients’hospitalization expenses,including social demographic variables,hospitalization information variables and clinical characteristic variables,among which patients’hospital stay,type of treatment,gender and other factors have more significant influence on hospitalization expenses.4.The hospital stay is the most important factor that directly affects the effect of hospitalization expenses,and other factors can also indirectly affect hospitalization expenses through hospital stay.