Analysis On Hospitalization Expenses In Some Grade A Class-three Hospital In Shandong Province

Excessive and unreasonable increase in medical expenses tums out to be the focus of the society.Although in the past few years,the increase speed of medical expenses has slowed down as the result of the implementation of the policy on medical expenses control.Facing with the problems "being unaffordable and difficult to see a doctor" and medical insurance system reform,how to reduce unreasonable medical expenses and increase the accessibility of health service is the target we need to achieve.Objective:To study related factors of length of stay and hospitalization expenses by analyzing the composition of inpatients and hospitalization expenses in a hospital. And to explore the methods to reduce the length of stay and inpatient expenses.Methods:Data were analyzed with SPSS 13.0 to describe and explain inpatients composition,length of stay,hospitalization expenses,and related factors.Main statistical methods include t-test,variance test rank test and correlation analysis.Results:There were 11472 inpatients in these three years,and the hospitalization expenses were 288 million,529 million and 491 million each year.1)19.3%of the inpatients are older than 65 which take the maximum proportion.The number of inpatients from obstetrics and gynecology department,general surgery department and internal pediatrics department were the most,accounted for 13.2%, 7.5%and 7.1%separately.Except for delivery,coronary heart disease and bronchus and lung cancers inpatients are the most,accounted for 4.2%and 3.3%of all the inpatients.There were 31.1%inpatient' length of stay between 6-10 days.There were 66.1%inpatients expenses less than 10 thousand.Hospitalization expenses increased 24.5%in 2005 than 2004,while decreased 14%in 2006 than 2005.2) Drug fee,medical treatment and nursing fee,check-up fee accounted for 43.3%, 32.8%and 8.4%of total hospitalization expenses.Average hospitalization expenses of inpatients older than 65 were the highest in all age groups,and accounted for 28.9%. Average hospitalization expenses of inpatients from healthcare department for cadres were the highest in all departments,and accounted for 9.4%.Hospitalization expenses of department of cardiology accounted for 5.1%.Average hospitalization expenses of coronary heart disease inpatients were the highest in all diseases,and accounted for 9.7%.Hospitalization expenses of bronchus and lung cancers accounted for 4.4%,and stomach cancers accounted for 3.0%.Hospitalization expenses of inpatients that length of stay is longer than 25 accounted for 30.6%.3) There were 0.7%inpatients hospitalization expenses higher than 100 thousand,but the hospitalization expenses of that group accounted for 10.3%of the total expenses. Inpatients from department of health care for cadres accounted 28.5%of the group hospitalization expenses.There were 9.8%inpatients that length of stay was longer than 25 days,while the hospitalization expenses of that group accounted for 30.6%of the total expenses.Hospitalization expenses of inpatients from healthcare for cadres department and radiotherapy department accounted for 17.7%and 12.1%of group total expenses.There were 89.3%coronary disease inpatients get better through treatment,61.8%bronchus and lung cancer inpatients get better,while 46.8%stomach cancer inpatients were cured.There were 82.9%coronary disease inpatients had a secondary diagnosis,while 18.3%stomach cancers inpatients had a secondary diagnosis.There was 14.2% coronary disease inpatients adopted surgery,while 45.2%stomach cancers inpatients adopted surgery. Conclusion:Compared with studies in the same period,there are no abnormal results. Negative growth of hospitalization expenses existed in 2006.Drug fee accounted for the highest proportion of total expenses,and check-up fee increased every year. However,the result that few inpatients groups take huge proportion of medical resources is worth considered,such as high hospitalization expenses group,long length of stay group and some diseases and inpatients from some department.So special expenses control policy focused on these groups would be more effective to achieve the goal of medical expenses control.Suggestions:1) Control ratio of medicine cost,increase the service value of medical staff;2) Enhance management and control level of high medical expenses;3) Cut down unreasonable length of stay;4) Promote the prevalence of DRGs,establish payment criterion of single diseases;5) Conduct inpatients referral,promote the ability of community health service;6) Ameliorate doctor-patient relationship,avoid "doctor protective prescription".