Analysis On The Constitutions Of Medical Expenses For Type ⅡDiabetes Patients And Its Related Factors

BackgroundDiabetes has become the third serious chronic non-communicable diseases after tumor and cardiovascular and cerebrovascular diseases, in many countries it has become one of the main reason of the rapid growth of medical costs and lead to disabled, death. Nearly30years, the prevalence of diabetes increased significantly. Raising from0.67percent in1980to3.21percent in1996. The situation of the prevalence of diabetes in nearly10years is more serious. Organized by the Chinese Diabetes Society which gave a epidemiological survey of diabetes on14provinces and cities nationwide, estimated that the prevalence of people who over age20with diabetes was9.7%.There are total about92.4million adults with diabetes in china, including43.1million in rural,49.3million in urban. Our country may have reach the number one in the patients of diabetes. With increasing number of patients, and the development of social and economic price index, medical expenses (including bed fees, inspection fees, treatment fees) is also rising, which gives individuals, families and society brought heavy economic burden.ObjectivesThrough review the patients’ medical record information from2008to2012in a tertiary level hospital in Shandong Province, regarded the first diagnosed as "type II diabetes," as the research object, analyzing its inpatient medical expenses, in order to understand the composition of hospital costs, trends and influencing factors so that we can control the excessive growth of health care costs and reduce the burden of patients.MethodsExtraction from January in2008to December in2012firstly diagnosed as "type II diabetes," on the patient’s medical record information, it including (1) medical record number, name, sex, age, marital status, category, the Frequency stay in hospital, diagnosis of Outpatient, the situation when enter the hospital and what the Diagnosis is、 the situation when leave the hospital and what the Diagnosis is、pathological diagnosis, injury or poisoning of external factors, drug allergy, rescue times and number of successful;(2) hospitalization cost information:total medical cost, bed fees,, inspection fees, treatment fees, surgery fees, laboratory fees, nursing care, meals, medicine costs, sanitary materials costs, herbs, blood transmission and some other costs (heating bills, air conditioning, etc.).This study was analyzed by descriptive study to understanding the basic composition of the hospitalization cost of patients, analyzing the various factors that changes in hospital costs in five years and compare the different fees that changes in different patient characteristics, the application of multiple linear regression analysis to analysis the impact factor of inpatient costs.when we determining the variables in this study we take several considered types of variables in patients which are closely related to hospital costs, such as inspection fees of patients, treatment costs, medicine costs, sanitation materials, complications, how long stay hospital and so on. Using Excel input the data, using SPSS13.0software to statistical analysis.Main Results1. This study collected4697patients with type2diabetes from the year2008to2012, the average age was about62years old;2522cases were male (53.69%),2175cases were female (46.31%); the average number of hospitalization days was12.73; the number of patients with medicare payment was3698(78.73%), the rest paid by their own (21.27%); the number of patients with type2diabetes complications was4280(91.12%); the number of patients with operation was269people (5.73%).2. Based on the present value of2012, the medical expenses of type2diabetes patients increased largely in2012, but changed moderately from2008to2011. Kruskal-Wallis test results showed that, the medical expenses among the5years had significant differences (P<0.05), pairwise comparisons showed there were significant differences of hospitalization expenses between2009and2010,2009and2012(P<0.0050), there were no significantly differences of the rest pairwise comparisons (P>0.0050);2008-2012per capita medical expenses changed gently, with some fluctuations but little changes annually.3. Univariate analysis found that age, gender, hospitalization days, with or without complication, with or without surgery had significant effects on medical expenses (P<0.05); multiple linear regression analysis indicated that age, gender, hospitalization days, with or without complication, payment styles, with or without surgery had significant influence on the medical expenses (P<0.05).4. Total medical expenses of the5-year patients with type2diabetes was58.02million yuan, of which the drug costs were most, accounting for54.88%, followed by the treatment fees, laboratory fees, accounting for13.60%,12.20%, respectively.5. the present study also analyzed drug costs, inspection costs, treatment fees, laboratory fees, bed fees and diagnosis fees, statistical analysis found that trends were different of different kinds of medical expenses.ConclusionsOverall, diabetes as a chronic hazard is extremely serious, its long duration and a series of complications which may seriously affecting people’s health and quality of life.It also make patients and their families face serious economic burden and pressure of life, so it should be received adequate attention in health and some related sectors. The medical expenses have increased in2012obviously, but hospitalization costs per person are12000-13000which are relatively stable. The medicine costs account for a large proportion of all the medical expenses, we suggest to reform the drug costs, to lower the drug price, and to control the medical expenses.