| Research purposesIn this paper,by studying the composition of the hospitalization costs of patients with ischemic heart disease in the sample hospitals from 2016 to 2020 and the main factors affecting the cost of hospitalization,this paper targeted to reduce the cost of hospitalization,reduce the burden of medical treatment,and alleviate the problem of "expensive medical treatment".Research methodsThis study selected the basic information,diagnosis and treatment information,hospitalization expenses and other related data of patients with ischemic heart disease(ICD-10 code I20-I25)in the sample hospital from 2016 to 2020.Descriptive statistical analysis of frequency and composition ratio was used for the basic information of patients;each component of cost was analyzed using new grey relational analysis method and structural variation analysis method;The Mann-Whitney U and Kruskal-Wallish H nonparametric test methods were used for one-way analysis of hospitalization costs,and multivariate linear regression was used for multivariate analysis.Finally,the path of influencing factors of hospitalization expenses was constructed by structural equation model method,and the main factors affecting hospitalization expenses and the influence degree of the main factors were discussed in depth.Research result1.Descriptive analysis of patients:The average age of the patients was 69.52±12.002 years old,and there were more males than females,accounting for 60.01%and 39.99%,respectively;the average hospital stay of the patients was 7.47±8.70 days;23.70%of the patients had undergone surgery.,11.31%had been rescued,and 17.12%of the patients had undergone clinical pathway management.2.Analysis of cost changes:The results of the new grey correlation analysis show that in the cost composition,the top three are consumables,medicines,and diagnostics;Costs have the greatest impact,followed by drug costs and comprehensive medical costs.3.Analysis of factors affecting costs:The results of multiple linear regression analysis showed that the factors affecting hospital costs were surgery,rescue,number of complications,clinical path,gender,payment method,age,and occupation.The results of the structural equation model showed that the influencing factors could not only directly affect the hospitalization cost,but also indirectly affect the cost through the length of hospitalization.Among them,whether or not surgery has the greatest impact on the cost,and other factors have the greatest impact on whether or not to operate,whether to rescue,whether to clinical path,gender,number of complications,payment method,occupation,and age.Analysis conclusion1.In 2020,the average hospitalization cost(after discount)of ischemic heart disease patients is 17,472.43 yuan,and the economic burden of patients is too heavy.2.In the composition of hospitalization expenses,the top three are consumables,diagnosis and medicines,which account for more than 80%of the total cost.According to the Pareto principle,attention should be paid to the structure of these three.Optimize,reduce the cost of consumables,inspection fees,and medicines,and improve the cost structure that reflects the value of medical staff s labor services.3.The top three factors affecting the cost were whether to operate,the number of days in the hospital,and the number of complications.Whether surgery has the highest impact is because the medical materials used in surgery are expensive,such as cardiac stents and interventional consumables.This matches the result that the cost of consumables accounts for the first place,suggesting that hospitals should promote a zero-addition policy for consumables and centralized procurement of consumables policy,to reduce the cost of consumables.4.Optimize hospital management,incorporate ischemic heart disease into clinical pathway management,scientifically shorten hospital days and carry out day surgery on the premise of ensuring medical quality. |
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