Analysis Of The Influencing Factors Of Hospitalization Cost Of Asopharyngeal Carcinoma In A Grade-? Hospital From 2012-2017

ObjectGuangxi is a high-risk area of nasopharyngeal carcinoma in China.By analyzing the hospitalization costs and influencing factors of nasopharyngeal carcinoma patients in a top-three hospital in Guangxi from 2012 to 2017,the change trend and main influencing factors of hospitalization costs of patients with nasopharyngeal carcinoma in this hospital were explored,which provided policy recommendations for controlling the increase of hospitalization costs.To provide reference for optimizing the allocation of nasopharyngeal cancer prevention funds,and to provide reference for related health administrative departments to formulate single-disease payment lines.Method Data collected from patients diagnosed with nasopharyngeal carcinoma in a grade-three hospital from 2012 to 2017,which were collected through the electronic medical records system.The general conditions?sex,age,marriage,ethnicity,region,and medical insurance payment category?and hospitalization information were extracted from hospitals.The inpatient days,first diagnosised,surgery,tumor stage,hospitalization expenses?including individual expenses?and other information,using a non-parametric rank sum test to analyze the influencing factors of hospitalization costs by univariate analysis,and there are statistically significant influencing factors.Multiple linear regression model analysis.Result 1.Statistical description of the general condition of the patient.The results showed that of the 7106 patients,5250?73.88%?were males and1856?26.12%?were females.The male to female ratio was 2.83:1;the patient's age was 10-83.Between the ages,the average age was 47.58±10.86 years;the number of married cases was 6589,accounting for 92.72%of the sample;517unmarried patients,accounting for 7.28%;the Han nationality was 3,773?53.10%?;the Zhuang patients were 3138(44.16 There were 195 cases?2.74%?in other ethnic groups;there were 2482 patients in this city,4427 in other cities in Guangxi,accounting for 34.93%and 62.30%of the total respectively.The source of patients in the province was as high as 97.23%;Mainly in the new rural cooperative medical system,there were 5,540 cases?77.92%?,and the number of patients with medical insurance accounted for 94.73%;2.A statistical description of the patient's hospitalization information showed that the majority of patients were hospitalized.There were 1,421 cases?20.00%?of nasopharyngeal carcinoma diagnosed for the first time,and 5685cases?80.00%?were hospitalized multiple times;many patients had no surgery.There were 6689 patients?94.13%?who had no surgical treatment and 417?5.87%?patients who underwent surgery.The average length of stay was17.58±21.422 days.Most of the patients were in phase III and IV.2811?39.56%?,3396?47.79%?,other types only accounted for 12.65%.3.Statistical description of the patient's hospitalization fee information.The results show that the average hospitalization cost of the patient is 1,7576.7 yuan.The average hospitalization cost,the average length of hospitalization,and the average hospitalization fee decrease year by year.The average daily hospitalization fee increases year by year.For the treatment fee,western medicine fee,examination fee,inspection fee,bed fee,other fees,nursing fee,and surgical fee,they are 39.97%,34.25%,10.34%,5.61%,4.53%,3.81%,1.25%,0.15,respectively.%.4.The single factor analysis of the total cost of hospitalization for patients showed:sex?Z=-5.552,P=0.000?,year of hospitalization?Hc=29.287,P=0.000?,payment type?Hc=31.509,P=0.000?,first diagnosis There were significant differences in six factors?Hc=-38.795,P=0.000?,surgical conditions?Z=-23.995,P=0.000?,tumor stage?Hc=180.225,P=0.000??P<0.05?.There was no significant difference in marital status?Z=-1.412,P=0.158?,ethnicity?Hc=0.219,P=0.896?,and source area?Hc=6.705,P=0.082?.The hospitalization days?R=0.881,P=0.000?and drug costs?R=0.901,P=0.000?were positively related to the total hospital expenses,respectively.There was no correlation between the age?R=0.019,P=0.102?and the total hospital expenses.5.The multi-factor analysis of the patient's hospitalization cost showed that the main factors affecting the hospitalization cost of patients with nasopharyngeal carcinoma were:stage of cancer,year of admission,number of days of hospitalization,drug charges,type of payment,gender,and initial diagnosis.The coefficient of determination R²=0.835 indicates that the goodness of fit of the regression model is good,and the multiple linear regression equation obtained is:Y=-23.179+0.020X₁+0.013X₂+0.013X3₈+2.7E-5X₅-0.006X₆-0.017X₈-0.025239X_9-2-0.083205X_9-3-0.040207X_9-4-0.024795X_9-5-0.061115X_9-6Conclusion 1.The incidence and mortality of Guangxi are high,and the burden of epidemiology is heavy.Early diagnosis and treatment should be actively carried out to reduce the incidence of nasopharyngeal carcinoma.2.The direct economic burden of patients with nasopharyngeal carcinoma is too heavy,and it is recommended that the medical insurance department increase the reimbursement rate for major diseases;3.The proportion of controlled drugs is the key to controlling the growth of hospitalization costs.The market price behavior of drugs should be regulated,drug additions must be abolished,and the structure of hospitalization fees must be adjusted in order to effectively reduce the proportion of drugs;4.The average daily hospitalization cost of patients with nasopharyngeal carcinoma increases year by year.Hospital management should be strengthened to ensure the treatment effect while taking into account the shortening of the average length of stay.