Cost Analysis And Influencing Factors Of Inpatients With Circulatory System Diseases In A Tertiary Hospital In Jilin Province In 2018

Objective:Based on the classification of international general ICD-10,to explore the distribution and influencing factors of the expenses of inpatients with circulatory system diseases in a three armour hospital in Jilin Province in 2018.It provides data support for the formulation of prevention and treatment plan of circulatory system diseases and the rational planning of medical insurance policy of circulatory system diseases so as to reduce the economic burden of diseases of patients.Methods:Use Excel 2016 to set up and organize the database,and make a descriptive analysis of the data.The hospitalization cost and length of stay of patients with circulatory system diseases were analyzed univariate by Mann-Whitney U test and Kruskal-Wallis H test.The recursive system model was used to analyze the direct and indirect impacts of each index on the hospitalization cost of patients with circulatory system diseases,and the influencing factors of the hospitalization cost were more clearly presented by drawing the path diagram.IBM SPSS 24.0 was used for data analysis,and the test level was α=0.05.Results:In this study,a total of 34,082 patient data that met the requirements were derived from the system,and the cost of hospitalization was 1.014 billion yuan,with an average of 7.98 days of hospitalization.Individual out-of-pocket expenses were17,676.95 yuan per time,with an average reimbursement rate of 40.61%.Among them,the age group of 60 years and above was the most hospitalized,and male was higher than female.Meanwhile,ischemic heart disease had the highest number of visits(13,996),followed by cerebrovascular disease(10,944).Among different medical payment methods,urban workers are the most,followed by the patients of new rural cooperative medical care system,urban residents and self-paid patients,accounting for 38.23%,27.21%,18.13% and 16.43%,respectively.In terms of average hospitalization cost per time,compared by age,gender,disease category and payment method,the highest groups were 15-59 years old group,male,chronic rheumatic heart disease and self-paying patients.The top three diseases in reimbursement ratio were ischemic heart disease(48.27%),cor pulmonale and pulmonary circulatory disease(40.79%),and venous,lymphatic and lymph node diseases,which could not be classified in other places(39.40%).Urban residents had the highest reimbursement rate,up to 58.68%,and the lowest out-of-pocket expenses.The second is urban workers,also 55.65 percent.The new rural cooperative medical system was the lowest,accounting for 36.81%.The final consequence of the recursive system model show that the length of stay has the most effect on the expenses of hospitalization;compared with people aged 15 to 59,the total effect value of children aged 0-14 on hospitalization cost was larger;compared with other types of heart disease,chronic rheumatic heart disease,arterial,small artery and capillary disease,hypertension disease,cerebrovascular disease and other diseases have a greater impact on the cost of hospitalization.Conclusion:1.The hospitalization cost of inpatients with circulatory system diseases in different groups was different,which showed that the age group of 60 years old and above has the highest number of patients and the highest average cost per patient.Average out-of-pocket expenditures are highest in the 15-59 age group.The number of in-patient and the average hospitalization expenditures per time in male patients were higher than that in female patients.2.Among hospitalized patients with circulatory diseases,the top four categories of inpatients were ischemic heart disease,cerebrovascular disease,other types of heart disease and hypertension disease.The most familiar disease in either sex was ischemic heart disease.In terms of the number of hospitalizations,other types of heart disease was maximum among people aged 0-14,and ischemic heart disease was maximum among people aged 15-59,60 and older.3.The number of hospitalizations and hospitalization costs of urban workers were the highest.However,due to the relatively low overall reimbursement ratio of NRCMS in circulatory system diseases,NRCMS patients had the highest per-time out-of-pocket expenses,which should be paid attention to.4.The top three disease categories of out-of-pocket expenses per time were chronic rheumatic heart disease,artery,arteriole and capillary diseases and cerebrovascular disease,which need to strengthen prevention and appropriately increase compensation.5.The number of days of hospitalization had the largest impact on the hospitalization cost of patients with circulatory system diseases in a three armour hospital in Jilin Province.Meanwhile,the influence of artery,arteriole and capillary diseases,hypertensive disease,children aged 0-14,cerebrovascular diseases and chronic rheumatic heart disease were slightly higher than that of other populations.