Analysis Of The Hospitalization Expenses And Its Influencing Factors In Patients With Medical Insurance For Urban Employees In A Hospital In Shenyang

With the development of social economy and medical level, people's living standard is rising, self-care consciousness is growing, and the demand for medical service is increasing day by day. As well, the total cost of health has risen sharply. China as the largest developing country is facing the problem of rising medical costs and a waste of resources. With the further development of medical reform, the coverage of medical insurance in China has been expanding, meanwhile the basic medical insurance institution has established the guarantee strategy of "low level, wide coverage", "income and expenditure, balance of income and expenditure". However, due to the increasing pressure of social population aging, the contradiction between the rigid growth of medical expenses and the limited ability in payment of medical insurance is increasingly obvious. The medical insurance and designated medical institutions are facing the dual challenges of improving medical quality and controlling medical expenses.Objective:The purpose of this study was to analyze the hospitalization expenses of the urban employees in Shenyang city in 2015, therefore to understand the distribution of hospital costs in the hospital. By exploring the influencing factors of hospitalization expenses to find out the regular and existing problems in the operation of the hospital staff's medical insurance patients, and put forward some related suggestions.Methods:The Excel database was derived from the HIS system, while the data were analyzed by SPSS20.0 software. P <0.05 was statistically significant. The descriptive analysis was used to describe the general situation of patients. The cost structure of hospitalization, the distribution of overall costs, etc. The rank sum test was used to compare the differences in hospitalization costs among different sexes, ages, types of staff and length of hospitalization. Multiple linear regression models on the cost of hospitalization.Results:Hospitalization cost composition: medical expenses in the composition of the hospital medical expenses, materials, laboratory fees and inspection fees accounted for 41.21% of hospital costs, otherwise 15.86%, 14.77%, 13.17%, which accounts for the highest proportion of drugs, and different demographic characteristics of Chinese medicine accounted for higher than other projects. Different types of diseases of drugs accounted for 37.50% ~ 62.26%, the proportion of ear and mastoid diseases was 62.26%, and the proportion of circulatory diseases was 37.50%, but the proportion of material cost was 20.29%.Analysis of influencing factors of hospitalization expenses: Hospitalized days are the influencing factors of hospitalization expenses. Staying in hospital for more than 28 days of the nine kinds of diseases-circulatory system disease, tumor and digestive system diseases three accounted for 67.74%; at the same time, these three kinds of diseases in various diseases are the total cost rankings ranked first, second, fourth. Personnel category is the independent influencing factors of hospitalization expenses. Among the staff and employees with different types of staff, the average cost and the average cost of each item were higher than those in the job. The retirement expenses accounted for patients, drugs and materials costs accounted for relatively high. Other influencing factors: by rank sum test, gender and age are the influencing factors of the total hospitalization expenses and the cost. In the multiple linear regression models, the influence of gender and age on the cost was not statistically significant. In this study, 45-59 years old patients with an average of 9761.94 yuan per hospitalization cost, followed by 60-74 years old patients for 9706.57 yuan.Disease burden of different diseases: the top three diseases of patients with health insurance sickness were circulatory system diseases(57.99%), nervous system diseases(7.93%), respiratory diseases(6.43%), and tumors(2.19%) ranked ninth. There were significant differences in hospitalization costs among different diseases. The most common diseases were the tumor(13749.29yuan), the circulatory system disease(10070.05yuan) and the respiratory system disease(9793.92yuan). The third disease was the musculoskeletal system and the connective tissue(7473.86yuan), ear and mastoid disease(7279.76yuan), the difference between the highest and the lowest of the disease cost was 6469.53yuan; the proportion of all kinds of diseases accounted for the hospitalization expenses as the highest. The top four outpatients with the highest average cost of hospitalization were: cancer, circulatory system disease, respiratory disease and digestive system disease; the top four highest average per capita compensation costs Diseases are: cancer, circulatory system diseases, digestive diseases and respiratory diseases, the two basically the same. However, the top four out-of-pocket costs were also cancer, respiratory, circulatory, and digestive diseases. In the case of tumor, the average compensation rate of tumor patients was the highest(8410.79yuan), but the compensation ratio was the lowest; the average cost of self-pay(5338.49yuan) were the highest in all types of diseases.Conclusions:In the composition of hospital costs, the highest proportion of drugs. Drugs accounted for the highest disease in the ear and papilloma disease, which accounted for the lowest disease for the circulatory system disease. Type of personnel and the numbers of days in hospital are the influencing factors of hospitalization expenses. The total cost of hospitalization and the hospitalization expenses of each item were higher than those in the job, the more the hospital stay, the higher and the cost of hospitalization. The average total cost of hospitalization was the highest, and the second was co payment and the four kinds of diseases were the highest in the kinds of diseases, such as tumor, circulatory system disease, respiratory system disease and digestive system disease. Three kinds of disease compensation for the highest percentage of genitourinary system diseases, ear and mastoid diseases and endocrine system disease, nutritional and metabolic diseases; since three to pay for the highest percentage of tumor, respiratory system disease and nervous system disease. Improve the medical insurance payment methods, to avoid blindly control the proportion of drug costs accounted for hospital expenses, medical expenses control mechanism should be based on long-term.