Analysis Of Hospitalization Expenses Of Elderly Patients In Grade ? Medical Institutions In Shihezi City After Elimination Of Drug Addition

Objective:Through the analysis of the hospitalization expenses,the internal structure of hospitalization expenses,the influencing factors of hospitalization expenses,and the satisfaction of hospitalization expenses of the elderly inpatients in the third-level medical institutions in Shihezi City before and after the cancellation of the drug-adding policy,we can understand the changes in the hospitalization expenses of the elderly hospitalized patients,and explore the implementation.The unreasonable part of the hospitalization expenses and the problems in the implementation process after the cancellation of the drug add-on policy provide suggestions for further improving the policy of eliminating drug additions and rationally controlling the increase in hospitalization expenses for elderly patients.Methods:According to the World Health Organization's classification criteria for the elderly,the largest third-level medical institution in the Xinjiang Corps system was selected as the research object for elderly patients aged 60 years and over from 2015.09 to 2010.09.The comparative analysis method was used to analyze the overall change of hospitalization expenses of elderly patients before and after drug addition.The structural change analysis method was used to analyze the internal structure changes of hospitalization expenses of elderly patients before and after drug addition.The multiple linear regression model was used to analyze the influence of hospitalization expenses before and after the implementation of the policy.In-depth interviews enable us to understand the satisfaction and recognition of hospitalization expenses for elderly patients after drug add-on.Results:1.The effect of hospitalization expenses control is obvious: after the drug addition is cancelled,the average hospitalization cost of the elderly hospitalized patients is slightly decreased,and the development rate of the average hospitalization expenses is 95.98%,and the growth rate is-0.04%.2.After the drug addition is cancelled,the structure of hospitalization expenses for elderly hospitalized patients changes a lot,and the fee structure is more reasonable: the change of hospitalization fee structure after cancellation of drug addition is 24%,and the drug fee,diagnosis fee and inspection fee are negatively changed.Surgery fees,nursing expenses,general medical service fees,treatment fees,sanitary materials fees,other fees,bed fees,anesthesia fees,medical fees,and blood transfusion fees are positively changing.3.The item that caused the change in the hospitalization cost structure of elderly patients after the drug addition has made some difference: the main factors that caused the change in hospitalization expenses before the cancellation of drug addition: medicine,medical expenses,sanitary materials,diagnosis fees,inspection fees.The cumulative contribution rate is 96.06%.After canceling the drug addition,it changes into the drug fee,surgery fee,nursing fee,treatment fee,and sanitary material fee,and the cumulative contribution rate is 78.65%.4.After the drug addition is cancelled,the representative hospitalization cost structure of elderly hospitalized patients changes significantly.However,the same cost category has different effects on the hospitalization expenses of patients with different diseases.5.The factors affecting the hospitalization expenses of elderly hospitalized patients after drug add-up are basically the same,but the degree of influence has changed remarkably: the effect of eliminating the drug add-on before hospitalization costs from large to small is: hospitalization days,surgery grade,medicine proportions,age,type of medical insurance,gender,and surgery.Regression coefficient were: 0.457,0.244,0.156,0.060,0.050,0.040,and 0.030 respectively.The effect of canceling the drug add-on on hospitalization expenses from high to small is: hospitalization days,surgery grade,drug proportion,hospitalizations,age,type of medical insurance,surgery,gender.Regression coefficients are: 0.426,0.242,0.089,-0.086,0.061,0.058,0.051,0.034 respectively.6.After the cancellation of the drug addition,the hospitalization expenses of the inpatients were not satisfactory: 68.75% of the patients expressed dissatisfaction with the current hospitalization expenses after the cancellation.Conclusion:1.The implementation of the drug add-on policy for a third-level medical institution in Shihezi City has achieved obvious results,basically achieving the expected goal of eliminating drug add-on.The hospitalization fee structure for elderly hospitalized patients is more reasonable,and the proportion of medicines in hospitalization expenses has been effectively controlled,reflecting project costs to reflect the value of medical staff service has increased,but there is still a problem of low proportion and small increase.2.The cancellation of drug add-on policy has played a positive role in optimizing the structure of hospitalization expenses for elderly patients,but its effect is limited.The medicine cost is still the highest,and the proportion of laboratory fees and inspection fees is decreasing,while sanitary material costs have risen significantly.3.The cancellation of the drug add-on policy doesn't fully meet the patient's demand for medical services,and other supporting measures need to be improved.