| Objective: Through statistical analysis of the hospitalization expenses for cerebral infarction patients in eight county hospitals in Liaoning province,we understand the distributive characteristics of the hospitalization expenses,and explore the main influencing factors.Design hierarchical management structure for hospitalization expenses by using statistical model,and compare disease characteristics and the expenses difference of the same disease among different expenses stratification of patients in the different regions,to provide reference for the payment reform of new rural cooperative medical system in Liaoning province.Methods: Describe the hospitalization expenses for cerebral infarction patients in eight county hospitals in Liaoning province using SPSS statistical software,explore hierarchical management structure for hospitalization expenses with percentile method and decision tree model analysis.Multiple linear regression multivariate analysis was applied to analyze the possible influencing factors of the hospitalization expenses.Results:1.4156 patients were collected from medical insurance database.2019(48.6%)cases were males while 2137(51.4%)females.The average age was 66.3±10.6 years(27-98 years old);35.6% cases were during 60-69 years old;56.6% cases wereoutpatients;70.6% patients had complications.2.Among the 8 hospitals,hospital A had the largest patients,accounting for 29.9%(1242),while the hospital Ehadthe least,accounting for1.3%(55);72.7% patients in hospital Ewere males while 15(27.3%)females.To be specific,patients in high age group had a higher average hospitalization expenditure than that in low age group.In the age distribution.32.7% patients were under 60 years in hospital E.13.8% patients were over 80 years oldin hospital H.3.The average cost of cerebral infarction was 6599.5±3850.5yuan(M=5961.5,IQR=3406.7);The average daily cost was about 655.0±338.6yuan(M=584.5,IQR=242),and the average length of stay was(M=11,IQR =7).Days of hospitalization of female(10.9 days)was higher than that of male(day 10.5).With the increase of age,the average daily medical expenses increased gradually.The hospitalization expenses for cerebral infarction patients in eight county hospitals have great difference.in the average hospitalization days,average hospitalization expenses and average daily.4.The hospitalization expenses for cerebral infarction patients in eight county hospitals have great difference in distribution.The average cost of hospital F is the highest,and the lowest is hospital A,that means the average cost of hospital A is only half of hospital F.The hospitalization expenses distribution of three groups are balanced among hospital H,hospital B,hospital D,and hospital C,but there are more than one time differences of high cost group in each hospital.5.Intrapulmonary infection and diabetes are two important nodes of case classification.6.Days of hospitalization,admission way,diabetes mellitus,intrapulmonary infection,hypertension,and the age are the main factors for hospitalization expenses.Conclusion:1.The hospitalization expenses for cerebral infarction patients in eight county hospitals have great difference in distribution,which affects the fairness of medical insurance payment.2.Intrapulmonary infection and diabetes are two important influencing factors of hospitalization expenses,but about 8.2% of the cases without any complication appear in the high cost group.The government should strengthen the supervision of medical service behavior,At the same time improve the ICD coding,and strengthen the construction of Hospital Information System.3.Days of hospitalization,admission way,diabetes mellitus,intrapulmonary infection,hypertension and the age are the main factors for hospitalization expenses.4.Through the hierarchical management of expenses,we can reduce the number of unnecessary and unreasonable medical expense,at the same time,we can reduce the number of hospitalization days.The great differences of hospitalization expenses among the 8 county hospitals in Liaoning province affected the fairness of medicare payment system.The government pay for expense and do some supervision according to the characteristics of disease and the cost difference between the different cost stratification of patients;At the same time,The government should maintain the quality of patients with severe condition and high cost of medical service and promote the enthusiasm of the medical staff. |
