Study On Influence Factors Of Average Costs And Length Of Stay Of Three Chronic Diseases In A Comprensive Hospital

Research BackgroundThe excessive growth of medical costs,"Difficult and expensive" has now become the broad masses of people and the focus of attention which is facing difficult problems of health system reform in China. According to the Ministry of Health survey data show that, of about48%of the residents are sick do not seek medical treatment, about27%of the residents should be hospitalized and not hospitalized, this description of the masses of basic medical services has not yet been met. China Consumers Association released the medical charges findings:85.1%of patients on hospital charges "unsatisfactory", are not satisfied with the reasons for the concentrated expression of its high proportion of92.1percent of the "expensive". The steep rise in health care costs, the share of medical expenses in the gross national product is also gradually increasing, the rate of growth of medical costs has exceeded the growth of the economic system service expenditures, facing our country in recent decades difficult. Especially with the socio-economic development and the improvement of people’s living standards, the gradual progress of the aging population, the gradual change of the demographic structure of human disease spectrum also undergoing constant change, the growing number of chronic diseases, social and patients the burden of health care costs will increase gradually. September7,2004, the World Health Organization published the aging population the health concerns of the community,"the report pointed out that, with the aging of the global population, the burden of chronic diseases to the public health system is getting heavier and heavier. Therefore, how to better regulate the allocation of health resources, effective use of health resources, control medical costs excessive growth, alleviate the financial burden on patients and to control unreasonable growth of health care costs is an important issue to be solved in China.ObjectivesDescribe the basic structure and changes of Baotou City General Hospital three chronic diseases (coronary heart disease, emphysema and chronic hepatitis) hospitalization costs and length of stay (length of stay), and analyze its impact factors for the effective use of health resources, control health care costs over fast growth, reduce the financial burden on patients, to improve the level of medical services to provide a scientific basis.MethodologyRetrospective survey analysis, collection of Baotou City General Hospital three chronic diseases (coronary heart disease, emphysema and chronic hepatitis) from December2007to December2010, Department of Cardiology diseases-coronary heart disease patients respiratory Medicine diseases-emphysema Department of Infectious Diseases disease-chronic hepatitis B, to investigate the socioeconomic characteristics of the patient, disease characteristics, treatment quality, the total cost of hospitalization and other components of data. Collected data to establish a database using Excel data using statistical software SPSS17.0affect hospital costs and length of stay univariate analysis and multivariate analysis, and to establish the factors that affect hospital expenses and length of stay, stepwise multiple regression equation, analysis of the patient’s hospital costs (total cost and material fees, inspection fees, treatment costs and fees of western medicine, nursing care and other) basic constitute circumstances from2007to2010, hospitalization costs and length of stay of changes in the situation, and analysis of patients with different characteristics (gender, age, length of hospital stay and pay etc.) and hospital fees, and to explore the impact of various factors on the cost of hospitalization and length of stay and Control StrategiesMain Findings (1)Hospital fee structure composed of three chronic diseases, the highest proportion of drug costs in the total cost of hospitalization, coronary heart disease drugs in the hospital accounted for58.70%of the total cost, obstructive emphysema drugs accounted for55.17%of the total cost of hospitalization chronic hepatitis drugs accounted for63.52percent of the total cost of hospitalization. The medicine technology than the and inspection technology than the relatively were higher in2009the chronic hepatitis drug technology than the maximum,7.08, inspection technology than1.43, indicating that the technical charge less medical procedures;(2)Univariate analysis of hospital costs and length of stay results:different socio-economic characteristics (gender, age and payment of the way)of hospitalized patients hospitalization expenses and length of stay have substantially with the difference, p<0.05,p<0.05, after rescue hospitalization costs and length of stay significantly higher than non-hospitalized after the rescue costs, p<0.05; The four years from2007to2010, the three chronic disease hospital costs showed a rising trend, the average length of stay for coronary heart disease and obstructive pulmonary emphysema slight downward trend, but no significant changes in chronic hepatitis patient days;(3)Multivariate analysis found that hospitalization costs:the number of days in hospital admissions and payment is three chronic disease hospital costs combined effect of factors, including the number of days of hospitalization is the most important factor for hospitalization costs.(4)Affect the results of multivariate analysis, patient days:admissions and age is the combined effect of the factors of three kinds of chronic diseases hospital stay, and admission is the most important factor in patient days, obvious complications on hospital day.Conclusion(1) he three chronic hospitalization fee structure composed mainly there are two aspects of the problem, first, the high proportion of drug costs in the total cost of hospitalization, embodies the technical lower value.(2) Univariate analysis found that hospitalization costs and length of stay: the socio-economic characteristics (gender, age, address, and payment) of the hospitalized patients, duration of hospitalization and illness severity has a significant effect on the cost of hospitalization.(3)Hospitalization costs impact and length of stay affect the multi-factor analysis showed that:the length of stay, admission situation and pay way affect various disease hospitalization costs of common factors, and length of hospital stay is the most important factor the various disease hospitalization date of the common admission circumstances and ageinfluencing factors, and admission is the most important factor in the length of hospital stay.Advice(1)Comprehensive measures to increase the government’s fiscal investment and change the hospital’s profit model, reducing the proportion of drug costs in the total cost of hospitalization, to reduce unnecessary tests, an appropriate increase in service charges of medical technology, fully embodies the value of the labor of the medical staff.(2)Improve the quality of care, reduce the ineffective, inefficient hospital days and thus shorten the hospital stay, lower average daily hospital charges.(3)Propaganda work to prevent illness, early doctors advocate sick, Shorten the hospital stay, to reduce unnecessary medical expenses.(4) Reform of the payment of the cost of hospitalization, the implementation of the medical expenses paid by disease, such as a single disease limit fees, to further improve the medical insurance system and the implementation of the policy, the reasonable control of the payment of medical insurance for hospitalization costs.