| BACKGROUNDNowadays, the medical expenses are increasing rapidly throughout the world. In the last20years, the disposable incomes of farmers and urban residents in China have increased by no more than20times, while the medical charges they afford have soared by133times. Moreover, the proportion of medical expenditure paid by residents grows from20%up to60%. For the past few years, with the increasing demand of health care, the impetus of social medical insurance and the rising drug price, the growth of medical expenditure in China is faster than that of economy. In2009, Chinese government published’Views on deepening the reform of health system’. It refers that the burdens should be reduced and the problem of’few hospital and high expenses’should be solved practically. Besides committing more funds to the health care industry, decreasing the charge of every single item in diagnosis and treatment could be the key to control the growth of medical expenditure. In recent years, with the development of social economy and the improvement of diagnosis and treatment, more and more cancer patients stay in hospital. The expenses for hospitalization have become a sensitive issue for every cancer patient, their family, also for society. The writer select to compare the specialized and general hospital, analyze the factors of hospitalization expenses for patients with gastric cancer, and then command the composition and feature of the hospitalization expenses in different hospitals by data analysis and informant interview.This essay tries to compare the different styles of medical services and internal management in various hospitals and discuss the effects they take on the hospitalization expenses. It provides a basis for the study of medical charge growth controlling and social medical system reform.OBJECTIVEThis study aims to find the influencing factors through analysis of patients with gastric cancer from Year2006to2011in the Specialized and General Hospital in Shanghai. In order to grasp the hospital expenses constitute its influencing factors, and correlation analysis by comparing the two hospitals result, the development of cost-control measures for health policy makers to better control the cost of hospitalization, proposing basis for decision and making policy recommendations.METHODOLOGYCollect discharge patients’ expenditure of a level III grade A cancer specialized hospital and general hospital in Shanghai.Data collection methods:medical records review, literature review.Data analysis methods:Multiple linear regressions, standard method, stratified analysis, T-test, chi-square test, variance analysis; Informant interviews methods.RESULTThere is a significant difference in hospitalization cost between the patients with gastric cancer in specialized and general hospitals. Patients with gastric cancer hospital cost a largest share of drugs; there was a positive linear-related relationship between the cost of hospitalization and inpatient days. The growth of the total cost of hospitalization is due to the increased number of days of hospitalization; There are some reasons cause the differences between two hospital, there are:(1) Medical services to treat gastric cancer after chemotherapy;(2) The use of surgical instruments;(3) Inconsistent classified information on the cost of hospitalization;(4) Different cost implications of the way patients are treated differently and so on.RECOMMENDATION1, Managing hospital day is an effective means to reduce hospital costs.2, Reducing the costs of medicines and controlling the excessive use of drugs are also the ways to reduce hospital costs.3, Control the use of disposable medical supplies, reduce the price of disposable medical supplies and medical4, Regulate the medical services to enhance the quality of disease management.5, Improve the medical service compensation mechanism to reflect the value of doctors.6, Strengthen the medical ethics education for doctors. |
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