Cost Accounting And Financing Policy Analysis Of Disease Prevention And Treatment For The Elderly In A Province Of Western China

Objective: This study measures the total expense of the prevention and treatment costs of the elderly and expenditure in different dimensions such as service function,institution distribution and financing plan in a certain province in west China.Analyze the service functions,distribution trends,funding sources and existing problems of the prevention and treatment costs of the elderly in the province in 2016,and put forward feasible suggestions.Methods: Based on the System of Health Accounts 2011 Edition,this study uses the up-tobottom apportionment method to measure the total amount of prevention and treatment costs in 2016 and with age as a variable,completes calculation of the expense based on the actual conditions of the province's health system;The cost of prevention is based on different prevention programs,combined with the population facing the prevention service,to determine the different proportions.Results: In terms of the overall scale in 2016,the prevention and treatment costs of the elderly in the province mainly flow to treatment services(89.80%),compared with the whole patient group,it is 3.65% higher;in terms of different service providers,the expenditure of the elderly mainly go to hospitals(76.25%),4.90% higher than the whole patient group;in view of financing plan,the source of financing for prevention and treatment costs primarily come from public funding(61.64%).Accounting analysis of the beneficiaries of the disease treatment costs for the elderly in the province,in terms of gender,elderly men spend more on outpatient services than elderly women,while in hospital expenditure,it shows the opposite;in term of age groups,the expenditure mainly go to the age group from 65-79,expenditure for patients of this group account for 80.55% of the total treatment expenditures of all the elderly,in term of disease distribution,the top four money-consuming diseases are circulatory system disease(34.48%),respiratory system disease(15.57%),tumor(8.38%)and digestive system disease(7.40%).According to the standards of the classification of disease burden,hospitalization costs contribute the most to the total expenditure of different diseases.Non-communicable diseases requires the highest treatment expenditure,with treatment expenditure accounting for 86.76%,outpatient costs accounting for 86.01% and hospitalization costs accounting for 87.02%.In term of institution distribution,most treatment expenditure occur in hospitals,accounting for 82.43% of the total,among which outpatient services account for 70.69% of the outpatient treatment cost and hospitalization accounts for 86.46% of the hospitalization treatment cost,Further research on hospital treatment costs,found that the largest hospital treatment costs occurred,general hospitals account for the most,up to 65.56% of the total treatment cost,and Chinese medicine hospitals account for 14.93% and specialized hospitals only 3.95%;treatment expenditure in units of the grassroots level account for 16.87% of the total cost,among which outpatient services account for 26.58% of the outpatient treatment cost and hospitalization accounts for 13.54% of the hospitalization treatment cost.By studying the distribution of treatment cost financing,it was found that it was mainly a public fundraising plan,accounting for 64.99% of the total cost,among which government accounts for 24.16% and basic medical insurance accounts for 40.83%;individual healthcare expenditure comes the second,accounting for 31.48% of the total treatment cost.In 2016,the prevention expenditure of the elderly in the province mostly occur in healthcare institutions of the basic level(61.10%).Funding for hospitals and health institutions of the basic level mainly come from enterprises and family health expenditure while public health institutions are mainly funded by the government.Conclusion: The health costs of the elderly in the province mainly occur in chronic noncommunicable diseases.The elderly in the province “emphasize treatment,contempt for prevention”,“emphasize hospitalization,and despise outpatient clinics”.The cost of treatment for the elderly in the province is excessively concentrated and flows to hospitals.The proportion of household expenditure in the prevention and treatment of diseases for the elderly in the province is relatively high.