Study On The Hospitalized Expenditure Among Patients With Hysterom Yoma And Its Influencing Factors

With the development of economy, the medical expense accounts for a larger and larger proportion in the Gross National Product for most countries. Therefore how to control the medical expenditure rapidly rising is becoming a worldwide problem, to which many governments and specialists are devoting their time and energy. They are looking forward to establish a medical serving system which can not only control the medical expenditure but also ensure the quality and justice.At present, there are three popular ways for medical charging. The first way is charging according the projects which is now being applied in our nation. That is to say, there is the medical treatment first, and then charging according to the treatments accumulated. The second way is being applied in the Great Britain. The government grants a fixed amount of money every year which is to be used by the hospital within the limitation. The third way is according to charges disease. There are advantages and disadvantages for every single charging way.Professor Cai Renhua from Shanghai Jiao Tong University argued that charging according the projects is good for the sophisticated method but is difficult to control the medical fees rising.For the hospital, the second charging way is not so easy to pluck up the courage to serve the medical treatment. Since the fees have been fixed, more treatments do not mean more revenues.According to charges disease has two advantages. It can stimulate medical serving for more revenues by getting more patients while control the unreasonable treatment in every single case. Hospitals got the motive for lowering the cost and improving the efficiency.To launch the according to charges disease system, we have got to study the hospitalized expenditure for every single disease. And this is the key point of this paper. This article used the hysterom yoma's patients of one hospital in the Jilin province from 2004 to 2007, we took a systematic analysis about the data. So we can grasp the distribution and the constitution of the hospitalized expenditure, and the influencing factors. All these can help the hospital policy-makers to formulate the expense control measures, and better control the hospitalized expenditure, to provide the positive reference, and so on. The article mainly included following contents: 1. The main characters of the samples. 2. Analysis about the expenditures. 3. Logistic-factorial analysis. 4. Conclusions and suggestions.The article got 691 medical records mainly including following contents: 1. General characters of the samples including age, burden form and so on. 2. Information of hospitalization, such as concomitant diseases, postoperative complications, hospitalization day, anaesthesia and so on. 3. Information about the charges.The statistical methods of this investigation contains the descriptive analysis, parametric and nonparametric test, the regression analysis of many influencing factors. The study used the SPSS13.0 statistical software package to carry on the statistical analysis.The research result mainly includes: 1. Surgery is the main therapy for hysterom yoma, the charges for medicine account for the biggest proportion in the hospitalized expenditure of the patients, about 25.36~30.99%, more than the surgery's 7.26~15.17%, which is unreasonable. 2. Consider the burden form, patients supported by rural cooperative medical service cost the highest hospitalized expenditure, self-supporting patients cost the lowest, the medical insurance supporting patients cost between them two. 3.The influencing factors of the hospitalized expenditure is various, and the hospital days number is an extremely important factor. 4.The hospitalized expenditure grows with time. 5.concomitant diseases, anaesthesia and postoperative complications can cause more expenditure. 6.The logistic analysis of influencing factors results showed that the factors include the anesthesia ways, burden form, concomitant disease, postoperative complications, age,the type of surgery.This article hold this view that the main causes which make the medical expenditure so high are as followed: high price of the medicines, the use of sophisticated equipments and one-time medical consumable materials, insufficient investment from the government, the social factors especially the higher standard of therapy.Based on the analysis, this article presents the recommendations as followed: 1. Receive the reasonable charge and reduce the drugs expense, avoid the medicine abusing, cease the undesirable tendency. 2. Prevent the abuse of checking and testing, make the reasonable inspections, reduce the burden on the patients. 3. Focus on the values of technical service from doctors and nurses. 4. Establish the community health service systems, so it can conveniently give habitants health services. 5. Apply the according to charges disease system. 6. Apply clinical pathway to manage the disease treatment. 7. Strengthen the education of medical ethics. 8. Make more revenue while consuming the medical service compensative mechanism, carrying on the macroeconomic regulation and control the medical expenditure. 9. Teach the public, focus on the health more than therapy.