| As the population aging,the living environment and the lifestyle changes,the trend of disease spectrum changes.The change of the disease spectrum will bring about the changes of the needs of the entire medical market.The grasp of disease spectrum is a series of evidences of stipulating medical model,formulating health policies to capture the goals of disease prevention and choosing the direction of health investment.At present,China's medical expenses are showing an excessively rapid growth trend.The problem of poverty caused by illness and returning to poverty caused by illness frequently occurs.Although the coverage of medical insurance is very wide,many patients still have "the difficulty and high cost of getting medical treatment".So it is very important to understand the inpatients' disease distribution and hospitalization expenses characteristics.And it can not only provide etiological clues,but also help identify key populations in key areas and key time,thus providing important evidences for the prevention and control of diseases,optimization of hospital clinical resource allocation.ObjectiveThe case information of inpatients in a tertiary hospital were analyzed in Shandong Province between 2014 and 2016 to understand the distribution characteristics of the inpatients.First,to understand the characteristics of the distribution of inpatients in the hospital during the three years.Second,to make an in-depth analysis of the main system diseases and single diseases from different dimensions such as year,gender,age,and regional distribution.Third,to analyze the main influencing factors of hospitalization costs.Providing basis for decision making for the adjustment of hospital medical resources and further control of hospitalization expenses.MethodsThe related disease data were classified according to ICD-10 based on the discharge diagnosis.Descriptive statistics and ?2 test were adopted to analyze the disease constitution by SPSS 22.0.The influencing factors of hospitalization costs were analyzed by ANOVA analysis and multiple linear regression.Using ArcGIS software for statistical map drawing.Main results?The number of hospital admissions in this hospital has been increasing year by year,and the month-change trends of the number of hospitalizations between 2014 and 2016 are generally in line.The proportion of hospitalized patients in male was slightly lower than that of females,and those aged 60 and above were high risk groups in hospitalization.?The number of inpatients who don't live in Jinan City is relatively high,nearly 16 percentage points higher than which in Jinan City.?It was found that the hospitalization constitution of the top 3 systemic diseases were factors influencing health status and contact with health services,neoplasms and diseases of the circulatory system between 2014 and 2016.The top 10 systemic diseases have more female patients than male patients except diseases of the circulatory system,digestive system,respiratory system and nervous system.?Among the single disease rankings,the top three are cancer chemotherapy,coronary heart disease,and cerebral infarction.The top 10 single diseases have more male patients than female patients except cancer chemotherapy and specific medical care,and those aged 60 and above were high risk groups.Children under 5 were high risk groups in bronchial pneumonia and those aged between 5 and 14 were high risk groups in epilepsy.?The average length of stay from 2014 to 2016 were 9.83,9.66,and 9.47 days,respectively.There were 67.7%inpatient'length of stay between 1-10 days.Systemic disease with an average length of stay of more than 10 days:external causes of morbidity and mortality(13.36d),neoplasms(13.08d),diseases of the circulatory system(11.30d)and diseases of the musculoskeletal system and connective tissue(10.64d).? The average cost of hospitalization from 2014 to 2016 were 20787.2,21721.5,and 23265.6 yuan respectively.Neoplasms(23%)and diseases of the circulatory system(21%)are the main components of hospitalization costs.There were 2.55%inpatients hospitalization expenses higher than 100 thousand,but the hospitalization expenses of that group accounted for 18.27%of the total expenses and diseases of the circulatory system are major diseases of patients with large hospitalization costs.The effects of year,sex,age,presence or absence of spouse,presence or absence of complications,presence or absence of surgery and length of stay on hospitalization cost were statistically significant.ConclusionThe inpatients in this hospital showed an increasing trend year by year.The proportion of hospitalized patients in male was slightly lower than that of females,and those aged 60 and above were high risk groups in hospitalization.The inpatients with chronic diseases such as neoplasms and cardiovascular disease accounted for the largest proportion.And the number of hospitalized patients with cancer chemotherapy,coronary heart disease,and cerebral infarction were top the list.The hospital's average hospital stay was below the national standard.The average length of stay in neoplasms and diseases of the circulatory system were longer,and the cost of medical care were also the main component of total hospitalization costs.Their medical care burdens were heavy and the medical resources consumed were relatively large.The hospital should reasonably allocate medical resources according to the disease distribution characteristics and make a good effort in supply-side reforms.As the year grows,patients who were male,older,unaccompanied,with complications and surgery paid higher hospitalization costs.Suggestions?Further strengthen chronic diseases building,focus on innovation and scientific research.?Help build the medical ability of lower-level hospitals to deal with intractable diseases actively and clear the transferring consultation channel.?Setting up the information sharing data platform to manage the chronic diseases patients scientifically.?Promote the concept of "preventive treatment of disease",shorten the average length of stay to reduce the medical burden from the source. |
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