Study On Hospitalization Expenses And Its Influential Factors Among Esophageal Cancer Patients Receiving Surgeries

Objective:The rapid growth of medical costs is of great concern to many developed and developing countries across the world. As the largest developing country, China is also witnessing the increase of medical costs and waste of resources. How to strengthen health economy management, lower medical costs, and make medical services more accessible to people have been the top priorities and challenges for the current medical care reform. Through the study of hospitalization expenses structure of esophageal cancer and its influential factors in a first-class specialized cancer hospital, the paper analyzes the constituent ratio of medical costs, providing new ways to conduct hospitalization expenses management of single diseases for hospitals, and statistical support for medicine and health management authorities, and medical insurance organizations to set payment standards in line with national conditions for single disease.Materials and methods:The paper focuses on the hospitalization expenses structure of esophageal cancer patients and its influential factors. Through retrospective investigation, the paper collects1384hospitalized cases that were first diagnosed as esophageal cancers, and then has them coded and analyzed according to ICD10. Based on the basic information from medical records, the paper studies such indexes as socioeconomic features and disease features of patients. Data about total hospitalization expenses of certain cases and their constituents are gathered from the hospital’s information center. All information, stored in a database in Excel, and analyzed with SPSS19.0, is used to discuss the impacts of relevant factors upon hospitalization expenses and propose corresponding methods.Results:The study focuses on expenses of the following ten items:western medicine, traditional Chinese medicine, laboratory test, diagnosis, surgery, examination, anesthesia, nursing, bed and others. The research shows that traditional Chinese medicine takes the largest proportion, with41.45%, exceeding that of surgery, with21.34%. In western countries, medicine only accounts for10%-20%in total expenditure, while the figure in China mounts to50%to60%. The fact that expenses for medicine are higher than that for surgery shows the irrationality of constituent ratios and compensation model for hospital charging, since esophageal cancer is mainly treated through surgeries. It also reveals that compensation for human labor is less than that for materialized labor so that technical services cannot be well demonstrated. Therefore, it is of great importance to control the hospitalization expenses, in particular medicine expenses, and increase service expenses.In the current research, results form univariate and multivariate factors suggest that the year of hospitalizing, length of stay, complications, comorbidities, payment methods and age have impacts upon hospitalization expenses. The length of stay has a significant impact on expenses. The longer patients stay, the higher the expenses are. The year of hospitalizing is also influential. The research results demonstrate that from2007-2012, hospitalization expenses have been increasing, and medical costs are becoming less affordable for people. However, due to economic factors like inflation, it cannot be simply concluded from the research that expenses are increasing. Complications would affect the expenses since infections and complications will lead to higher hospitalization expenses. Another factor is comorbidity. Comorbidities such as hypertension, diabetes, being treated while treating esophageal cancer, would add the hospitalization fees, In the research, payment methods, though related to the expenses to some extent, make no significant differences. Expenses are significantly different in terms of age. The elder ages lead to higher expenses since the elder patients would have slower recovery and are more susceptible to infections, complications and other diseases.Conclusion:Expenses on western medicine, surgeries, laboratory tests and others, taking a large proportion, serve as the key points in controlling hospitalization expenses. Influential factors include the year of hospitalizing, length of stay, complications, comorbidities, payment methods and age. Length of stay, having a positive correlation with hospitalization expenses, affects most. Hospitalization expenses are not evenly distributed every day, with higher daily expenses in earlier period. The research also finds that different payment methods would not make significant differences in expenses. Men from50to69turn to be the most vulnerable population in getting esophageal cancer. Controlling single-disease cost, strengthening health economy management, conducting accurate and rational cost accounting, and reinforcing drug use and inspection control, are essential to lower hospitalization expenses. Single-disease clinical pathway management is supposed to be strengthened via reforming management models. Setting and specifying diagnosis and treatment procedures for all diseases can help to regulate practitioners’behaviors, and reduce medical resources waste, so as to ensure and improve medical quality. Making scientific single-disease clinical pathways according to evidence-based medicine and implementing single-disease payment are vital to lower hospitalization expenses and should be carried out.