Study On Hospitalization Expenses Of Choledocholithiasis Endoscopic Lithotomy Tendency And Related Factors

BackgroundThe excessive growth in the total cost of medical services has been a very hot social issues, not only in many countries in the world, but also in China.Since2002, hospitalization expenditure had already been the large part in medical expenses. According to statistics, hospitalization expenditure had been higher than clinic expenditure, which had been the main reason for the excessive growth in medical expenses. Therefore, the excessive growth of hospitalization expenses has been one of serious focused problems in our society, in recent years, it has already been a important and difficult issue in health system in our country. Investigation and analysis on the hospitalization expenditure and its effect factors has been a basic problem in our health system reform at present, which would be has a very important meaning to reasonable exploiting and effective using the limited health resources, reducing medical cost and decreasing the excessive growth of medical expenses..In Inner Mongolia Autonomous Region about the unreasonable growth of medical expenses, hospitalization expenses and drug cost were two main factors causing the rapid growth, found by investigating. It was also exist in the single disease admission fee, unreasonable phenomenon either. But there was no report about the effect factors of medical expenses of Inner Mongolia Autonomous Region. This paper is to study the hospitalization expenses variable trend and expenses related effect factors in one hospital in Inner Mongolia Autonomous Region. In order to provide evidence and reference for rational control the excessive growth of medical expenses effective using of limited health resources and perfect of medical insurance system.ObjectivesTo study the hospitalization expenses and effect factors by choledocholithiasis endoscope lithotomy in GI department in one hospital in Baotou city. In order to provide evidence and reference for effective using of health resources, rational control the excessive growth of medical expenses and perfect of medical insurance system.MethodsRetrospectively review and analyze about the clinical information of501choledocholithiasis endoscope lithotomy patients in GI department in one Baotou hospital from November2007to November2010. The data was collected by using an Excel database, was performed and analyzed with SPSSversionll.O.The multiple linear regression model was used to analyze the total hospitalization cost and composition the change trend of hospitalization cost from2007to2010, analyze the relation between the hospitalization cost and the different character of disease(stone size, number, preoperative complications and so on),to find the effect factors of the hospitalization expenditure and its control measures.Results(1) Within four years, from2007to2010, choledocholithiasis endoscope lithotomy patients, the average total cost of hospitalization was in an upward trend, that the hospitalization fee in2010is1.53times than in2007, and the main reason is increasing the material cost in2010is2.58times than in2007. Secondly, examination cost also increased which the average fee is2386.41yuan, the examination cost in2010is1.74times than in2007.(2) The hospitalization expenditure is mainly related to preoperative or postoperative complications, and the cost of patients with postoperative complications or preoperative complications is significantly higher than the cost of patients with no complication.(3) The hospitalization expenditure is also related to the number of hospital days, that the longer the period of admission, the higher the cost of hospitalization.(4) The hospitalization expenditure is related to age of patients, the cost of patients more than60years old is1.46times than the cost of patients less than40years old.(5) Within four years, the rate of new rural cooperative medical insurance has been increased by13.01%, and the rate of self-paying medical services has been reduced by12.07%.The hospitalization expenditure is related to mode of payment, the cost of the mode of medical insurance and free medical service is significantly higher than the cost of self-paying medical service.(6) The hospitalization expenditure is related to the number of stone, the more the number of stone, the higher cost of hospitalization.(7) Within four years, the average daily cost of hospitalization had gradually shown a increasing trend.(8) By stepwise multiple regression analysis showed that the hospitalization costs had been affected by various factors, including the stone number、 preoperative complications、postoperative complications、the period of admission、 age、payment method and so on.Conclusion1) Within four years, from2007to2010, choledocholithiasis endoscope lithotomy patients, the average total hospitalization cost and average daily cost of hospitalization showed a significant increasing trend, and material cost was increasing significantly;2) Material cost and medical cost were the mainly two effect factors to compose the hospital cost which accounted for69%of total hospitalization expenditure;3) Within four years, the coverage of new rural cooperative medical has been increasing, and self-paying medical service has been reduced significantly and postoperative complications has been reduced significantly;4) The cost of hospital has been effected by a lot of factors, including stone numbers%postoperative complications、preoperative complications、the number of days hospitalized、age and mode of payment.Suggestions1) Enrich the financial investment and change profit model of hospital or medical center.2) Gradually increase the coverage of insurance, further complete the rules of insurance and reasonable manage the medicare expenses to insurance companies and hospital. 3) Improve the management and the quality of service of hospital, cut the low to no efficacy admission days then shorten the period of hospitalization and inhibit the unreasonable enrichment of hospitalization expenses.4) Health knowledge propagation have to be done regularly and widely, in order to promote prevention of disease consciousness of public, to attain this aim of "three early"’, early detection early diagnosis、early treatment, decrease complication happen.