Study On Affecting Factors Of Medical Expenses Of CRC In A Level3-A Hospital In Shanghai

BackgroundIn recent years, with the increase of malignant tumor’s incidence and mortality rates, the diagnosis and treatment cost rose up significantly. In order to control the rapidly increasing of medical cost in a reasonable range, it was necessary to investigate the cost and to find the factors, which affected costs.The case payment by the disease diagnosed has been demonstrated successful measurement in the controlling the increases of medical cost and improving the efficiency of the medical services.ObjectiveThe study was designed to investigate the costs and to find the influencing factors by analysing the medical costs for dignosis and treatment for colorectal cancer patients. From the analyses the commensts and suggestions would be proposed for controlling the increase of expenditure. And it tried to provide proposals regarding to how to improve the existing payment and pricing system and to make it more reasonable and practicableMethodThis study enrolled917cases of colorectal cancer treated in Fudan University Shanghai Cancer Hospital, and collected all the clinical data from patient charts and the medical charges from the financing department. A retrospective statistical analysis was carried out. This study was a descriptive statistics analysis with rank sum test and multiple linear regression.ResultMedicine charge, treatment charge and examination charges accounted for the top three of the total expenditure. The regression analysis showed that the influencing factors of the expenditure was various, including adjuvant chemotherapy, times of hospitalization, hospitalization days, adjuvant radiotherapy, complications, and mode of payment Discussion and recommendationgive more publicity to the screening,early diagnosis and early treatment; control the hospitalization days in a reasonable range by the clinical pathway, rein in drug prices and inspection cost and the total medical expenses; change inversion phenomenon of technical service charges and drug price; reforming compensation mechanism,carry out case payment by disease diagnosis system...