Analysis Of Medical Expense And Influencing Factors Of The Farmers Of The New Rural Cooperative Medical System With The Four Surgical Diseases In The Upper Second-class Hospital In Tangshan

1 Research Purposes"New rural cooperation medical service gathers", NRC for short, is a newly emerging concept existing during our country health reform process,which fully manifested that government pay lots of attention on the livelihood. However, because the current medical system limitation (such as government insufficient investment, hospital pursue economic efficiency, Unscientific medical service pricing, overelaborating medical equipment and drugs sales chain and so on),"NRC"must be influenced without a doubt. Actually, no matter"NRC"or basic medical insurance for township dwellers, they all face rising in price for medical in varying degree. This research analyzes patients'medical expenses in hospital for 4 kinds of surgical department diseases from one Tangshan second-level first-class hospital, understands safeguard effect gathered from the new rural cooperation medical service for farmers, analyzes controllable key factors of medical expense growing, finds questions during the action taking process and discusses regarding solutions.2 Research MethodsChooses acute appendicitis (good appendectomy), the uterine leiomyoma (good myoma excises technique), the adenoid body large (good adenoid body excision method) and in the nose separates deflects (in good nose to separate deflects orthotics) 4 diseases from one Tangshan second-level first-class hospital from January 1st, 2009 to December 31, 2010 as samples. Based on non-parameter statistics as well as multiple linear regression, analyzes patients'medical expenses in hospital and controllable key factors of medical expense growing.3 Research Results(1) Patients at their own expense and length in hospital are lower than other types of patients. The factors constituting hospitalization cost are increased in different degree except NRC.(2) Comparing within the fee of four kinds of patients with surgical diseases, drugs, surgical fees and laboratory test fees account for huge part of hospital cost. Drugs cost are increasing for all four kinds of patients with surgical disease; surgery cost is showing decrease trend, except for patient with uterine; laboratory tests cost keeps same, but only for the two decreasing nasal septum, it tend to be dropped.(3) Compared the hospital cost for four kinds of patients with surgical diseases and the part farmers are timely, the total cost of hospitalization rise and the part farmers are responsible is showing a downward trend.(4) IICA patients on demographic characteristics and disease characteristics, the single factor analysis conducted on this basis, multiple stepwise linear regression analysis. Patients with acute appendicitis IICA hospital costs and whether other diagnoses, the use of special materials, length of stay, the proportion of drugs, surgery are positive and significant linear relationship between the proportion; uterine leiomyoma IICA inpatient costs and the use of special materials, Are there any other diagnosis, length of stay, the proportion of medicines, surgical and laboratory scale there is a positive linear relationship between the proportion; hypertrophy IICA and whether the cost of hospitalization in patients with other diagnoses, the use of special materials, operation ratio, the proportion of drugs positive linear relationship exists; deviation of nasal septum in patients with or without other diagnoses, the use of special materials, length of stay, the proportion of drugs, surgery ratio, the proportion of tests are positive and significant linear relationship.4 Conclusions(1) Policy-induced phenomenon affects hospital.(2) Moral hazard on hospital cost.(3) Farmer itself affects the hospital costs(4) Components of the cost of hospitalization affect hospital cost.(5) Extended hospital stay of patients increased costs.5 Suggestions(1) Strengthen audit supervision for designated medical institutions.(2) Improve professional level and ethics of medical staff.(3) Regulate the urban and rural health seeking behavior.(4) Strengthening control for fees of drugs, surgery and laboratory tests.(5) Shorter hospital stay is effective means of reducing the cost of hospital cost.