Analysis On Hospitalization Expense Structure In Operative Inpatients With Primary Liver Cancer And Its Payment Management In Medical Insurance

Objective:This study focuses on the hospitalization expense of primary liver cancer inpatients,the data from 2014 to 2016 was collected in order to analyze the medical cost and explore a reasonable Diagnosis Related Groups payment method for the policy-making for the medical health system,as a further comment,to build a payment management of critical diseasesMethods:The study choose the information of the clinical treatment among the patients of primary liver cancer who have operations when they where in hospital at once in a hospital in Nanjing from 2014-2016.There are 912 reasonable and effective cases.The total expense was adjusted according to the CPI at first.Secondly,analyzing the internal and external influencing factors of the total hospitalization expense.Then,use the CRT in data mining technology to set up the case mix models of surgery patients of primary liver cancer and to explore a scientific and reasonable payment and its payment criteria with DRGsResults:1.the average cost of primary liver cancer inpatients was 60310.59 yuan,Western medicine,supplies category,diagnosis and surgical treatment category was the top there of the total hospitalization expense.Western medicine was the highest cost,accounting for about 40%of the total cost.2.The new gray correlation analysis found that the correlation of Western medicine was the largest of all,followed by the cost of supplies and diagnostic costs.Structural change analysis suggests that the change of total cost was caused by diagnostic costs,supplies category and Western medicine costs.3.The hospitalization costs were influenced by many factors such as age,sex,complications,medical insurance,clinical classification and so on.4.Separate cases by using CRT algorithm is more readable and can provide better explanations in both statistics and the specific clinical practice.Suggestions:1.It's necessary to build up a standard treatment plan of primary liver cancer.2.A reform of payment methods which focused on DRGs should be promoted 3.Preventing moral hazard while ensuring treatment quality.4.Early screening and controlling aflatoxin are the very important way in controlling primary liver cancer...