Study On Hospitalization Expenses And Influencing Factors Of Cataract Patients In One Of Top-three Hospitals In Qingdao

Objective:This paper analyzes the hospitalization expenses and their influencing factors of cataract patients discharged from a top-three hospital in Qingdao from January 2013 to December 2017,finds out the main factors affecting the hospitalization expenses,and puts forward some suggestions for controlling excessive growth of hospitalization expenses.Comparing the hospitalization expenses and their composition before the abolition of drug bonus reform(January 2013 to June 2016)and after the reform(July 2016 to December2017),this paper analyzes the reform effect of the cancellation of the drug bonus policy,and provides reference basis for deepening the comprehensive reform of public hospitals.Methods:Extraction of home page information of all cataract discharged patients from 2013 to2017 in the hospital information system database,including sex,age,household registration,payment methods,hospitalization days,concomitant diseases and types of operation.A total of 5003 valid cases were collected.SPSS21.0 software was used to analyze the data by descriptive analysis,single factor analysis and multivariate analysis to explore the influencing factors of hospitalization expenses in cataract patients.Results:1.The hospitalization cost of cataract patients showed an upward trend from 2013 to2017.Before the drug bonus was abolished,Among the hospitalization expenses,the proportion of consumable costs was the highest(51.94%),followed by treatment costs(25.75%),comprehensive services costs was the least(2.89%),The proportion of drug costs was 4.42%.The year-on-year growth rate of hospitalization expenses was on the rise.After the drug addition was abolished,the proportion of treatment costs was the highest(43.71%),followed by consumable costs(34.32%),The proportion of comprehensive services costs increased(3.28%),the proportion of drug costs decreased to 2.36%,and the year-on-year growth rate of hospitalization expenses decreased.2.The results of single factor analysis showed that there were significant differences in the total cost of hospitalization among different patients with different age,household registration,marital status,payment methods,working status,hospitalization days,concomitant diseases and types of operation(P<0.05).There were significant differences in comprehensive service costs among different household registration,marital status,payment methods,working status,hospitalization days,concomitant disease and operation types(P<0.05).There were significant differences in diagnostic costs among different age,household registration,marital status,payment methods,working status,hospitalization days,concomitant diseases and types of operation(P<0.05).There were significant differences in treatment costs among different age,household registration,marital status,payment methods,working status,hospitalization days,concomitant diseases and types of operation(P<0.05).There were significant differences in drug costs among different age,marital status,payment methods,working status,hospitalization days,concomitant diseases and types of operation(P<0.05).There were significant differences in consumable costs among different gender,age,household registration,marital status,working status,hospitalization days,concomitant diseases and surgical types(P<0.05).There were significant differences in other types of costs among different working status,hospitalization days,concomitant diseases and types of operation(P<0.05).The difference of hospitalization expenses before and after the implementation of drug bonus policy was statistically significant(P<0.05).3.The results of multivariate analysis showed that the influencing factors of hospitalization expenses of cataract patients were drug bonus,hospitalization days,operation types,household registration,age,concomitant diseases and payment methods,R~2=0.291.The influencing factors of comprehensive service costs were hospitalization days,drug bonus,working status,concomitant diseases,marital status and types of operation,R~2=0.488.The influencing factors of diagnostic costs were drug bonus,hospitalization days,working status,marital status and age,R~2=0.244.The influencing factors of treatment costs were drug bonus,types of operation,working status,concomitant diseases,payment methods and household registration,R~2=0.422.The influencing factors of drug costs were drug bonus,hospitalization days,concomitant diseases,types of operation and payment methods,R~2=0.293.The influencing factors of consumables costs were drug bonus,hospitalization days,working status,concomitant diseases,types of operation and household registration of patients,R~2=0.125.The influencing factors of other kinds of costs were hospitalization days,working status,concomitant diseases,drug bonus and types of operation,R~2=0.101.Conclusion:1.The hospitalization expenses of cataract patients showed an upward trend from 2013to 2017.The abolition of drug bonus reform significantly affected the increase trend of hospitalization expenses,and the growth rate of hospitalization expenses slowed down significantly after the reform.2.The cost of hospitalization is affected by many factors,such as age,hospitalization days,types of operation,concomitant diseases,payment methods,drug bonus and so on.3.After the drug bonus was abolished,the structure of hospitalization expenses changed obviously,which was mainly manifested in the increase of the proportion of labor expenses and the decrease of the proportion of drug costs and consumable costs.