The Study On Medicare Expenses And Influence Factors Of Pneumonitis Inpatients

Objective: The ability of prevention and diagnosis is improved while the medicalexpenditure is soaring with the swift progress of increase of new technology, medicalrequirement and new drugs. The economic burden of patients and country ispunctuated. So it is very important to decrease the hospitalization cost and handlemedical resource properly from studying the consist of hospitalization cost andcontrolling the main influence factors.Methods: To analyses the medicare expense, the 8706 pneumonitis inpatients whoare in our hospital from 2003-1-1 to 2005-7-1 are chosen. The collected data include:the first pages of their medical records and their balance bills, age, sex, condition ofin hospital and departure, the length of stay, season's groups. We study thecorresponding influence to the hospitalization cost of these factors by statisticalanalysis. Using Spssl 1.5 package, the social characters for data are statisticallydescribed, which included ANOV,multiple comparison in ANOV,one-way analysisof variance, regression analysis, multiple regression, nonparametric-test,Kruskal-Wallis test.Companding with speciality and data of medical records, We alsouse multiple regression to evaluate the effect of 13 elements which are introducted byexploration variance for hospitalization cost. We also study the inpatients'medicalrecords of mycoplasma pneumonia by using hospitalization cost data. We evaluatethe rationalizations of examination, test and drugs from analysis results.Results: The peak of 8706 pneumonia inpatients who are studied is 0.1-6years old, and the rate of danger children is 85.74%,the peak of them is 0.1-1 year old. Thepeak of ordinary patients is 0.1-6 years old, the rate of curative is 89.4%,boys aremore than girls.The pencent of pneumonia is 36.4%, the percent of broncho pneumonia is42.1%,the sum of them is 78.5%,so they are ordinary type.The results show that the component of drugs, treatment and test is 80-90%intotal cost, that the cost on drugs is the most important influence factor for the cost,its cumulative is 28.6%;The hospitalization cost increase with age in five groups.The cost of 6-14 is the highest and the cost of over 14 years old is the lowest; Thecost of serious case is higher than ordinary one; The cost of curative case is higherthan recovering; Winter and spring are the peak periods of pneumonia; The costincrease with frequency for hospitalization and the length of stay. The order ofmedian of cost is: mycoplasma pneumonia＞viral pneumonia＞pneumonia＞broncho pneumonia by pathological diagnosis.The results of ANOV show that length of stay,sex, age, condition of in hospitaland departure times in hospital are the main influence factors. After that, we build agood equation by multiple regression, and there are 13 factors have relationship tothe cost.(costs on drugs, oxygen, test, examination,length of stay,medicare, age,condition stay,medicare, age, condition of in hospital and departure, season'sgroups)We also study the inpatients'medical records of mycoplasma pneumonia byusing medical records data. The rate of serious case of mycoplasma pneumonia is92.4%,and the rate of curative case is 98.3%,and about 87% patients fall in illnesswith other disease together. Many children are compounded with pneumoniainfection. The reason of death is organ breakdown and poisoning,this is difficultpoint of treatment. The analyse result of cost on drugs, test and examination alsosupport this point.The cephalothin antibiotic drugs is 82%in total drugs cost, which the thirdgeneration cephalothin antibiotic drugs is 90%in total cephalothin antibiotic drugs. After all, the study also shows the properly control suggestions eg. jigingproperly examination, drugs, test to decrease unmerited examination, drugs, test. Wecan increase the proportion of medical technology to decrease the cost of drugsthrough inviting public bidding. We should strength health building of communityand execute DRGs and PPS gradually to readjust the component of cost to meet thepatients demands which they are satisfied with reasonable price.