Study Of Influence Factors On Hospitalization Expenses Of Elderly Patients With Grading Diagnosis And Treatment Of Baiyin

Objectives The research based on the basic conditions of population which participated in hierarchical medical treatment in Baiyin and the composition of the inpatient disease status,through analyzing influencing factors of elderly patients over 60 years old with chronic disease.Its aim is to seek for a appropriate statistical method of exploring future research on the issues related to hierarchical medical treatment,in order to puts forward the policy recommendations for formulating a scientific and rational health development policy by government department.Methods After getting the data of patients with hierarchical medical treatment from the NCMS database in Baiyin during 2015 to 2017,this paper import collected data into Excel 2007 and use SPSS 20.0 to generally describe the status.This study infer influence factors of hospitalization expenses by using non-parametric test,and analyze changes and trends of each component of hospitalization expenses of elderly patients over 60 years old by using grey correlation analysis and the degree of structure variation,and analyze the direct and indirect effects of various factors on hospital expenses of elderly patients with chronic disease by using recursive system model.Results(1)From 2015 to 2017,the number of patients with hierarchical medical treatment have continuously increased,the number of males lower than females.The number of patients flow to county level medical institutions is the most,followed by primary medical institutions,otherwise municipal level medical institution's patients is the least.(2)The top five diseases are respiratory system disease,circulatory system disease,musculoskeletal and connective tissue disease,urogenital diseases and digestive system disease of the patients with hierarchical medical treatment,and the number of people accounted for 78.19%.The rank of disease category have a difference with different age and gender group.(3)The hospitalization expenses of hierarchical medical treatment are concentrated in below 1000 yuan group,and this group decreased year by year.And the most composition ratio of hospitalization expenses is medicine fee,followed by the laboratory fee,treatment fee and so on.The actual compensation ratio lower than allowable medical expenses ratio.(4)The number of patients over 60 years old have gradually increased,and the proportion of during 60 to 74 years old group show a downward trend,otherwise over 75 years old group show an upward trend.The result of grey correlation analysis show that the greatest impact on hospitalization expenses of elderly patients is the medicine fee,followed by other expenses,laboratory fee,treatment fee and so on.(5)The result of the degree of structure variation show that the medicine fee,treatment fee and laboratory fee are main project which caused the structure changes of the hospitalization expenses in the elderly patients.The cumulative contribution rate up to 70.53%.(6)In this study,there are variables that have both direct and indirect effects on hospitalization expenses of elderly chronic diseases are whether municipal level medical institutions and primary medical institutions,whether cerebral infarction,coronary heart disease,lumbar disc herniation and so on.Conclusions(1)The implementation of hierarchical medical treatment in Baiyin have achieved achievements,and improved the utilization of residents' health services,and made the patients flow to medical institutions more reasonable.(2)The result of the greatest impact on hospitalization expense of elderly patients is the medicine fee show that the phenomenon of “medicine for the medical” still exist.And treatment fee show a trend of negative changes and it is necessary to optimize the composition of hospitalization expenses.(3)The actual compensation ratio of hospitalization expenses needs to be improved.(4)The patients over 60 years old were mainly chronic diseases and chronic obstructive pulmonary diseases ranked first in Baiyin.The greatest effect of the hospitalization expenses is the hospital in the county level medical institutions and hospitalization days.(5)The recursive system model is scientific and reasonable,it is suitable for analyzing the influencing factors for chronic diseases over 60 years old and obtaining the direct and indirect effects of the hospitalization expenses.