The Study Of Single Disease Cost Structure And Influence Factors Of A Military Hospital

Objective:The level of human demand for health care is increasing with the population expansion, the aging of society and the environment pollution. Meanwhile, like other countries in the world, China is also facing the situation of rising medical costs with the development of medical technology. Many western developed countries have taken the "related disease group (DRGs) as the standard charges prepaid" classification system, as an effective way to suppress the rising medical costs. All along, China has seen the single disease payment system reform as an important measure to get rid of drugs to support medical situation, and to achieve the target of public welfare. It is of great significance to study the single disease payment management with clinical path basement.Methods:This study collected the hospitalization expenses and other related data of three kinds of single disease (orthopedics of lumbar disc herniation, knee osteoarthritis, femoral intertrochanteric fracture). Basing on the existing literature, the data of three kinds of single diseases was analyzed by statistics with Kruskal-Wallis Test, Mann-Whitney Test, multiple stepwise regression analysis and other statistical methods. And the hospitalization cost of single disease was studied, to make clear the structure of hospitalization expense, hospitalization expenses influence factors and its action intensity.Results:We found that the cost of drugs and consumables constitute the highest proportion (≥45%), followed by diagnostic treatment (35-40%), in the hospitalization costs of three orthopedics single diseases. The influence factors of three kinds of single diseases are not exactly the same, but the hospitalization days before and post operation of disease characteristics, the age of social and economic characteristics are the main factors affecting the cost of hospitalization. In addition, gender, the kind of pay and admission situation were also has a certain effect on the hospitalization expenses of some single disease.Conclusion:The influence factors that can affect the patient’s hospitalization expenses of single disease are divided into controllable and uncontrollable factors. The military hospital should take scientific and feasible measures to improve the quality of single disease management, starting from the controllable factors. Meanwhile, the state and the army medical department should strengthen cooperation and support the military hospital greatly in the macroeconomic policy support, as for creating more favorable conditions in the management of single disease. Preliminary results of this study will provide some feasible measures of the management of single disease in military hospital, provide some basic data for the implementation of single disease management based on clinical pathway for military medical institutions, and also provide a theoretical basis for the health administration departments making health care policy.