The Study On Influencing Factors Of Medical Expenditure And Control Based On Cost Estimation

Background: In recent years,reform of the pharmaceutical and health care system in our country have achieved remarkable progress in key areas like medical security,the system for basic drugs and public health services.But the expenditure on disease still higher than before,there still have far to go to relieve people’s burden of disease.External factors are changing conditions,internal factors are the basis of change.And therefor,study the connection of hospital costs and hospitalization costs combine to adopt the homologous measures with manage would support hospital really serve the people and control the expenditure growth.Objective: The study aims to find the connection of the hospitals cost and expenditure on disease.Analyze the effects of cost structures change with the expenditure and make related suggestions for hospital management and development and how to control the expenditure on disease.Methods: The paper choose A and B hospital at the county level in NingXia as samples.Measure and calculate the cost of hospital and disease through the research method like literature review,interview with the experts concerned,on-the-spot investigation,economic approach and statistical approach.Analyzed the structure and the influencing factors of the expenditure on disease.Finally find how main cost factor influence the expenditure.Results1.The situation of estimate and structure of the hospitals cost: The prime cost are labor and administration cost.The cost of labor comprise 36.57% of the total,administration cost comprise 26.55% of the total in hospital A.The labor cost comprise 31.78% of the total,administration cost comprise 15.84% of the total in hospital B.2.The situation of the diseases cost estimate: There have three methods used to estimate the cost of the diseases.The three methods are project cost,sickbed days cost and clinical pathway.The measurement results shows,the cost estimated by clinical pathway is more reasonable.3.The analysis result of the structure and influencing factors on medical expenditure: the medical expenditure consists of sickbed expense,diagnosis expense,medicine expense,assay expense,nursing expense,operation expense,examinations expense and the other expense.The percentages of medicine and the other expense are higher than the others.The result of factor analysis shows display the medicine expense,the other expense and examinations expense are the major influencing factors.4.The influences of hospital cost on medical expenses: the equation by multiple step-wise regression analysis of A Hospital display the regression coefficient of the medical staff amount is 0.625,average days of hospitalization value is 0.157,the number of clinic project value is 0.133,the medical equipment value is 0.055.The equation by multiple step-wise regression analysis of B Hospital display the regression coefficient of the medical staff amount is 0.699,average days of hospitalization value is 0.245,the number of clinic project value is 0.201,the medical equipment value is 0.102.This paper shows that the cost factors such as the number of labor personnel,the value of the equipment,the average number of hospital stay and the number of clinical items are the main factors influencing the medical expenses.Suggestions:1.The management and development of the health information and communication in country-level hospitals shall be strengthened.2.Improved the financial management level in country-level hospitals and pursue the full-cost accounting3.Bringing the labor and administrative costs in hospitals under control and make full use of accessible resource4.Enhancing human-resources management and building talent group5.Transforming the ideology of the hospital management and change the way of the hospital management and implement the clinical way management6.To facilitate a reasonable drug pricing and price regulation,reduce in-hospital medical expenses and improve the operation efficiency of hospital7.Reformed of hospital compensation system and trying to facilitate the recurrence of the public interest nature of the hospital...