Analysis Of The Hospitalization Expenses Of Municipal Health Insurance Patients In The Top Three Hospital In Changchun

Objective:By understanding the basic situation of municipal health insurance patients of Changchun and their hospitalization expenses,the internal structure changes and the impact of external factors,factors that may influence analysis of hospitalization costs,explore effective interventions for hospital management personnel to carry out cost management and cost control system and establish reasonable and effective way,to curb the unreasonable increase of inpatient expenses to provide practical basis for decision-making,hospitals and patients achieve win-win situation.Methods:This study is to consult the domestic and foreign literatures about the medical expense and the policy documents through literature research;using the descriptive analysis to o understand the distribution of sex,age,length of hospital stay and the basic situation of municipal health insurance patients,hospitalization expenses;using structural changes to understand the internal structure changes of hospitalization expenses of municipal health insurance patients in 2013-2015;Grey relational analysis was used to analyze the relationship between various costs and hospitaliza-tion expenses;the statistical software SPSS20.0 was used to deal with the data of municipal health insurance patients,and the Kruskal-Wallis Test was used for univariate analysis;Taking ln hospitalization cost as the dependent variable,the factors such as age,sex,nature of the cost,type of personnel and payment method were used as independent variables,Multiple linear regression analysis was used to analyze the hospitalization expenses.Results: In 2013-2015,the number of municipal health insurance hospitalized patients and their hospitalization expenses increased year by year,the number of female patients was higher than that of males,more 45-60 and 60-75 of the two groups the number of patients over 60 years of age and the number of proportion increased year by year;There are a large number of patients in the Department of Cardiology and the tumor center,and patients with cardiovascular and cerebrovascular diseases and malignant tumors,the total number of prepaid patients than other payment methods.The analysis of structural change showed that the average hospitalization cost of drugs was the highest,followed by the cost of integrated medical service,the per capita hospitalization cost of blood and blood products is the lowest;the structural change of hospitalization expenses was the largest in2013-2015,which was 4.25%,and the structural change of hospitalization cost was the smallest in 2013-2014,the structural change of 2014-2015 was 3.32%.Changes in the structure of the ntegrated Medical Serv in the three years are positive changes in the treatment,drugs and blood and blood products in the past three years are negative changes.In 2013-2014,the largest contribution rate to the structure change of hospitalization expense is the cost of treatment,which is 37.02%,in the year 2014-2015 and 2013-2015,the biggest contribution to the structure change of hospitalization expenses is the comprehensive medical service,which are 50% and 50.12%.Gray correlation analysis showed that the correlation degree between various kinds of expenses,Drug expenses are the highest,followed by comprehensive medical services,treatment,diagnosis,the lowest correlation is the blood and blood products.Univariate analysis shows,there was a significant difference in hospitalization costs between different gender of the municipal health insurance patients(P<0.001);there was significant difference in hospitalization costs between different age groups(P<0.001);the difference of hospitalization expenses among different municipal health insurance patients was statistically significant(P<0.001);There was a significant difference in the hospitalization expenses between the patients with different mode of payment(P<0.001);There was a statistically significant difference in the cost of hospitalization caused by infection during hospitalization(P<0.001);There was significant difference in the hospitalization expenses between the municipal health insurance patients with different hospitalization days(P<0.001);There was a significant difference in hospitalization costs between different types of patients(P< 0.001).Multiple linear regression analysis showed that hospitalization duration,mode of payment,whether the infection of admission,and age are the main factors affecting the cost of hospitalization,the categories of personnel and cost properties had little effect on hospitalization expenses.Conclusion:1.In 2013-2015,the number of municipal health insurance patients and the cost of hospitalization of some grade a class-three hospital in Changchun increased year by year.2.Hospitalization costs increased year by year,its irrationality is mainly reflected in the cost of drugs,although the growth rate has declined,but the highest proportion of hospitalization expenses,the highest correlation with the cost of hospitalization.At the same time,the correlation between the cost of medical services and the cost of hospitalization is second only to the cost of drugs,and the two need the attention of medical workers and hospital managers.3.According to the different classification variables(cost nature,gender,age,payment method,admission,hospital stay,infection,personnel category)analyze hospitalization costs,found that the differences in the cost of hospitalization between the categorical variables were statistically significant,the number of hospitalization days,payment methods,infection,admission and other variables have a greater impact on hospitalization costs.4.The state and the government should further deepen the reform of the medical and health system,medical institutions clear function positioning,promoting the reform of payment system,improve the diagnosis and treatment of drug zero profit policy classification,report the level of health care,reduce the medical burden of patients.Based on this,the hospital should strengthen internal management,improve and optimize hospital management rules and regulations,improve the level of medical service and medical quality,the reasonable control of medical expenses into clinical departments,and clinical performance,stimulate their initiative and enthusiasm.