Analysis On Hospitalization Expenses And Influence Factors Of Coronary Heart Disease Patients In A Third-grade Class-A Hospital In Shandong Province

Nowadays, excessive increase in medical expenses turns out to be an issue of people throughout the world, and cause the attention of many countries' governments. Excessive increase in medical expenses become the confront problems all over the world. Keeping the medical costs reasonably growing and coordinated development of health career and economy have become the shared goals both in developed countries and developing countries. The present medical system in our country aims to control high medical costs, adjust health resources and protect all the society memebers. The focus hospital is the largest, most comprehensive hospital in Shandong province which patients who have the serious diseases come from all over the china.Research ObjectivesThe research aims to set up a reliable way of controlling the rapid increase of the medical expenses by analysising the hospitalization expense data of coronary heart disease in the aiming hospital, understanding the distribution of hospitalization expenses and discussing the influence factors of hospitalization expenses. To explore the effective way of establishing a reasonable hospitalization expenses system.Materials and MethodsThe study collected 10632 cases of Coronary Heart Disease from January 1, 2004 to October 31,2009 in the hospital which is third-grade class-A hospital in Shandong Province. The data of the patients, including base situation, disease burden forms, patient's hospitalization information, expenses and constitution,inputing those data to the hospital computer center, using the basic information on the first page of case. All the information is established and checked in Excel, using the SPSS 16.0 statistical software to get descriptive information of single disease, using nonparameter order test to analysis the single infector, and using multivariate stepwise regression method to analysis the factors by Factors Analysis System, to discuss the influence factors of Coronary Heart Disease and the controlling measures.of its hospitalization expenses.ResultsThe results of this study are abundant. The main results are as follows:1) Generally, the biggest cost in the patients' cost list is treatment costs, it's 47.4%-61.2%, secondly is medicine costs, it's 26.2%-39.5%, the treatment and medicine costs account for the most part of total expenses, all above 85%.2) The patients of Coronary Heart Disease whose age are between 55 and 80 are the biggest team.3) The patients of Coronary Heart Disease who stay in hospital between 10 and 19 days are the biggest team; it has a percent of 46.9%.4) The male patients of Coronary Heart Disease have a big part. It's about 65%.5) Concluding from the patient's vocational distribution situation, the proportion of farmer workers is 23.5%, which is the largest, followed by organs, enterprises and institutions, which proportion is 22.3%. The third is professionals, accounting for 16.3%, and the three groups above accounts for 62.1% of total number of patients.6) The number of patients and the average daily cost are increasing from 2004 to 2009.7) The single factor and multi-factor analysis show that the impacts of hospitalization fees are extensive, including years, sex, age, whether to switch departments, the length of hospitalization days, entering hospital condition, leaving hospital condition, blood transfusion, identity types, occupation, drug allergy and average daily hospital bills, hospital infection. Among them, average daily expenses, the length of hospitalization days, blood transfusion, form of payment, the intervention treatment, whether to switch departments are the main factors affecting hospital expenses.Conclusions and Recommendations:Conclusions:1)In the cost of hospitalization, the proportion of treatment costs and medicine cost are too much, should attract the attention of the relevant departments.2) Coronary heart disease is the highest number in the elderly patient population, and incidence trends to a younger age.3) Length of hospital stay in coronary heart disease is much longer, length of hospital stay is the main factors in affecting the cost of hospitalization.4) Men should pay more attention to prevention of coronary heart disease.5) Urban workers are the main groups of coronary heart disease,We should pay more attention to strengthening the health education for this part of population.6) The increasing number of patients with coronary heart disease, and hospitalization costs continue to rise,those things should attract the attention of society to reduce the incidence of coronary heart disease, improve medical services and reduce hospitalization costs.7) The average daily hospital costs, length of hospitalization stay, whether the blood transfusion, form of payment, weather intervention treatment, whether to switch departments are the main factors in affecting the cost of hospitalization.Recommendations:1. Increasing government investment, improving community health service system.2. Reducing the average daily hospital costs, shortening hospital stay, controling medical cost increases.3. To strengthen the medical system, improve the health care system.4. To reduce unnecessary medical services, reducing hospital costs.5. To strengthen rational drug use, adjusting the structure of drug costs. 6. Learning from foreign experience, changing the form of payment for medical expenses.7. Set a good medical ethics, standardizing medical care behavior.