Research Of Characteristic And Medical Care Cost Of Inpatients In A Children Hospital

Objective: By analyzing the patient's characteristic and the diseases speciesstructure, the status and the major influencing factors of the Children Hospitalsystematically, to improve the medical care service mode and quality of the hospital.By adjusting the comprising of medical care expenditure reasonable and using themedical resources efficaciously, to decrease the patient's medical care expenditureand control the medical care expenditure of the family and the whole society.Measures: The retrospective method was used, by adopting all the inpatient's dataand information in 2005(about 18740 cases), putting them into database by SPSS10.0,using the SPSS 10.0, to carry on description and statistical analysis.Results: In 18740 inpatients (male 69.86ï¼…female 30.14ï¼…), the group of5years-old and below 5 is occupied 84.26ï¼…, and the group of 6years-old and above 6is occupied 17.74ï¼…; The average hospital day of inpatients is 9.96 days; The numberof inpatients about Neonateâ…¡Department, Emergency Department, InfectionDepartment, General Surgery Department, Nerve Medical Department, DigestionMedical Department, Urinary Surgery Department, Blood and Immunity Departmentare occupied 62.97ï¼…of the hospital; the average expenditures per time (AE/T) of thepatients is about 4894.28yuan; The neonate's average expenditures is about7830.22yuan, the average expenditures per time of the patients who have operation isabout 7000.40yuan, and the average expenditures per time of the patients who do nothave operation is about 4329.74yuan. The top ten disease species with the largestnumber of patients are: pneumonia (11.49ï¼…), acute bronchitis (5.83ï¼…), pneumoniaof newborn (5.66ï¼…), infectious diarrhea (4.21ï¼…), asthmatic bronchitis (3.54ï¼…),Oblique inguinal hernia (2.61ï¼…), acute tonsillitis (2.59ï¼…), infant pneumonia(2.43ï¼…), hyperbilirubinemia of newborn (2.30ï¼…), epilepsy (2.16ï¼…), whichoccupied 42.81ï¼…of all the inpatients; The disease with the highest averageexpenditures per day are: hyaline membrane disease of newborn; neonatal respiratorydistress syndrome, Fallot pentalogy, inborn ventricular septal defect, congenital alveolardysplasia, foreign body in bronchus, is about 2142.522yuan, 1352.88yuan,1335.01yuan, 1231.37yuan and 944.21yuan; The top ten diseases with the highest costs are: inborn ventricular septal defect, hyaline membrane disease of newborn,neonatal respiratory distress syndrome, Fallot pentalogy, congenital alveolar dysplasia,congenital biliary atresia, brachial plexus injury, encephalitis B, congenital megacolon,Pyeloureteral junction angusty, premature infant with low viability, congenitalmatrotation of intestine, purulent meningitis, acute lymphocytic leukaemia and so on,and the highest in them are the front 3. The structure of the medical care expenditureis: medicines (35.63ï¼…), the examination and assay (26.94ï¼…). The income frommedicines and examination is big in the gross income, and the problem of 'raising themedical service by medicine' is not solved foundationally. The hospital has reflectedthe department characteristics, like the department of Neonatus, Emergency, UrinarySurgery, Physiatry, Special course of study and so on. But the others departmentshave not formed obvious predominance. At the same time, the hospital still have thedevelopment space of the hospital service with 6years older children; The structure ofhospitals' income is reasonable basically, but from the view of department and thediseases species, the criterion and the strict control is necessary.Results: In 18740 inpatients (male 69.86ï¼…female 30.14ï¼…), the number of malechildren is more than the female children; The main body of the hospital departmentsare Neonateâ…¡Department, Emergency Department, Infection Department, GeneralSurgery Department, Nerve Medical Department, Digestion Medical Department,Urinary Surgery Department, Blood and Immunity Department(62.97ï¼…) Thehospital is famous for the departments of the Neonate, Urinary Surgery andRehabilitation. The number of the inpatients with the disease of respiratory system isthe largest (31.54ï¼…). The average expenditures per time (AE/T) of the inpatients isabout 4894.28yuan, The neonate's average expenditures is about 7830.22yuan, theaverage expenditures per time of the patients who have operation is about7000.40yuan. The structure of the medical care expenditure is: medicines (35.63ï¼…),the examination and assay (26.94ï¼…). The income from medicines and examination isbig in the gross income, and the problem of 'raising the medical service by medicine'is not solved foundationally. The top ten diseases with the highest costs are: inbornventricular septal defect, hyaline membrane disease of newborn, neonatal respiratorydistress syndrome, Fallot pentalogy, congenital alveolar dysplasia, congenital biliaryatresia, brachial plexus injury, encephalitis B, congenital megacolon, Pyeloureteral junction angusty, premature infant with low viability, congenital matrotation ofintestine, purulent meningitis, acute lymphocytic leukaemia and so on, and the highestin them are the front 3 (is about 19417.25yuan, 19133.07yuan and 17846.52yuan).Proposal: Based on the character of the Children Hospital, it is necessary toimprove the establishment and the environment of the medical care service, and tobuild a childish and colorful environment; Start with the common disease andfrequently encountered disease, the hospital should strengthen the management of themedical services cost, for instance, to shorten the average hospital day, to adjust thestructure of inpatient's expenditure, to control the unreasonable expenditure onexamination and medicine. All these measures about lighten the burden of the patientswill go deep into every medical care service the and whole hospital; As a provincialhospital, it is necessary to strengthen the special departments and excellent experts inorder to face the aboil competition of the medical care service market. Bycontraposing the trend of children medical care service market, to inaugurate the newarea of the medical care service. By translating the medical care service mode, tochange the mode of "the patient is the center" into "the health is the center". All thesemeasures will make the hospital become to the children health center with children'shealth promoting, disease preventing, and healing.