Analysis Of The Hospitalization Expenses And Its Influencing Factors Among Elder People Of A County Level Hospital Of Huludao City In 2017

The aging population has become an enormous challenge in the course of the Chinese health development.The declined physical function,the increased morbidity and incidence of chronic diseases,and increased the need for health services promote the health expense for elderly people,which has impact on the elderly individuals,families and society.It is an important public health problem in an aging society that how to meet the health service needs of the elderly and improve their life and health quality.The rural medical and health service system in public hospitals at the county level play a leading role,become the important guarantee of county economic and social development.To analyze hospitalization expense of elderly patients and explore the influencing factors in a county hospital will help to formulate suitable health care policies for the elderly.Objective:This study understands the current distribution of hospitalization expenses and explores the influencing factors of hospitalization expenses of elderly patients in a county-level public hospital,which provide a theoretical basis for the formulation of health care policies for the elderly.All the hospitalized elderly patients over 65 years old in a county-level hospital in Huludao City from January 1 to December 31,2017 are studied.The data of gender,age,occupation,type of marriage and household registration,admission pathway,discharge pathway,operation and type of disease are collected,as well as the total hospitalization costs,comprehensive medical service costs,medicine costs,diagnosis and treatment costs and consumable materials costs through the medical record system.Epidata3.2 software is used to establish a database,SPSS 23.0 software is used for statistical analysis,non-parametric rank sum test is used for univariate analysis to understand the differences of total hospitalization costs and various hospitalization costs among different demographic and clinical characteristics of patients,and multivariate linear regression is used for multivariate analysis.The study aims to explore the impact of demographic and clinical characteristics on hospitalization expenses.Results:1.The total number of hospitalized aged 65 years and over in a county hospital in 2017 is 4071,of which 52.5% are males and 47.5% are females,26.8% are 65-70 years old,26.9% are 71-75 years old,24.2% are 76-80 years old and 22.1% are more than 81 years old.The elderly inpatients are mainly farmers,accounting for 67.95% of the total number of inpatients.2.The average hospitalization expenses of the elderly patients over 65 years old in a county-level hospital is 5515.30 yuan.The proportion of drug costs in the average hospitalization expenses is the highest,accounting for 39.28%,followed by the diagnosis and treatment costs,accounting for 22.43% of the total hospitalization expenses,and the third is the comprehensive medical service costs,accounting for 16.05% of the total hospitalization expense.Consumable materials costs accounts for 4.58%.3.Multivariate linear regression analysis shows that the type of household registration,admission pathway,the days of hospitalization and whether or not the operation has a significant impact on the average hospitalization expenses(p < 0.05).The effect of commercial medical insurance or medical assistance on hospitalization expenses is statistically significant(p<0.05).The effect of disease types on hospitalization expenses is statistically significant(p<0.05).Tumors,respiratory diseases,circulatory diseases and digestive diseases are the causes of high hospitalization costs in the elderly.However,gender,marriage,occupation and leaving pathway have no significant effects on hospitalization expenses(p > 0.05).Conclusion:1.The average of hospitalization expenses for elderly people in county hospitals is 5515.30 yuan,and the most are the costs of drug and treatment.2.The increase of hospitalization expenses was significantly related to age,and the cost of hospitalization for the elderly is significantly increased.To do well the health care for the elderly is beneficial to the control of health cost.3.Hospitalization days are the factors that lead to the high hospitalization expenses of elderly patients.The establishing the system of tiered medical services and reducing hospital hospitalization days are beneficial to the elderly patients health cost control.4.The elderly inpatients have the higher hospitalization expenses by emergency.It is good for the health management of the elderly who are at high risk of emergency,and reduce the hospitalization cost of elderly patients.It is beneficial to control the health expenses of the elderly patients to do well the health management for the elderly who are at high risk of the emergency department and reduce the hospitalization from the emergency department.5.Tumors,respiratory diseases,circulatory diseases and digestive diseases are the reasons for the high hospitalization expenses of the elderly.Establishing the priority control strategies is conducive to the control of health expense in elderly patients.