Analysis On Trend And Influencing Factors Of Insured Inpatients With Type 2 Diabetes

Objective:To investigate the influencing factors and trend of hospitalization costs of type 2 diabetes mellitus inpatients in Tianjin from year 2004 to 2011. New Gray Correlation Analysis and Degree of Structure Variation Analysis were used to analyze the cost of expenses components on hospitalization expense, in order to know the impact of expenses components on total hospital costs. We also used Univariate Analysis, Multiple Linear Regression Method and the Structural Equation Model to identify the associations between influencing factors and total hospital charge. Finally,we describe the changing trends of eight years on hospitalization costs. This study can provide a certain valuable references for the government on policy formulation and expense control of type 2 diabetes mellitus inpatients.Methods:We conducted a retrospective analysis using the Tianjin Health insurance database with 50 percent random sampling, from year 2004 to 2011. We collected40688 cases on type 2 diabetes mellitus inpatients(ICD-10 code is E11) to describe the patients and hospital characteristics. New Gray Correlation Analysis and Degree of Structure Variation Analysis on hospital charge were conducted with Microsoft Excel 2010; the influencing factors were analyzed by Multiple Linear Regression Method with SPSS 17.0 and the Structural Equation Model with AMOS 7.0.Results: The hospital charge was between 5500 yuan to 8000 yuan per patient during8 years, which descended between year 2004 to 2006 and then increased since year2007. Medicine took the highest proportion of the hospitalization costs, the followings were examination and treatment, these three costs were accounting for the majority costs of hospitalization, above 90 percent each year.Results from the univariate analysis demonstrated that gender, age, personnel sorts, hospital degree,insured area, number of complications and categories of complications were significant determinants for hospitalization costs of type 2 diabetic inpatients(p<0.05).The result of multiple linear regression showed that the major influential factors were length of stay(‘b=0.412), hospital degree(‘b=0.334)and number ofcomplications(‘b=0.195).Age, gender, length of stay, hospital degree and number of complications were the influencing factors of hospital costs, which were showed in the result of structural equation model. Age and gender were regarded as patient characteristics to had an impact on costs with the path coefficient of 0.10. Length of stay, hospital degree and number of complications were regarded as hospital characteristics to have an impact on costs with the path coefficient of 0.91. Length of stay also had an direct impact on hospital costs with the path coefficient of 0.14.Conclusion: In this study, the internal structure of hospitalization expense was unreasonable, and medicine took the highest proportion of the hospitalization costs.The result of multiple linear regression showed that length of stay, hospital degree and number of complications were the major influential factors; Age, gender, length of stay, hospital degree and number of complications were the influential factors in structural equation model, and factors also had direct and indirect impacts on each other. Among these factors, hospital characteristics were demonstrated that accounting for the majority of the hospital costs.