Research On Hospitalization Costs And Casemix Of Nephrotic Syndrome Of Lanzhou Tertiary Hospital

Objectives: To understand the internal constitution and influence factors of hospitalization costs for patients with nephrotic syndrome(NS),this study analyzed the hospitalization expenses of NS from 2013 to 2016 in tertiary hospital in Lanzhou City.Based on the above analysis,the decision tree was used to conduct case groups on NS,which provided a reference for the disease diagnosis related grouping of patients with NS in Lanzhou,and provided theoretical support for the treatment of patients with NS and the control of hospitalization expense in some hospitals.Methods: The data of this study was derived from the statistical information network direct reporting system of Gansu Provincial Health and Health Commission,according to the inclusion and exclusion criteria,2399 cases were finally obtained.In the descriptive analysis of the variables included in the study,the categorical variables were expressed by the constituent ratio(rate),and the continuous variables were analyzed by the mean,median and inter-quartile range;the degree of structure variation method and the grey correlation analysis were used to analyze the internal composition of hospitalization costs;multiple linear regression analysis was used to research the influence factors of hospitalization expense,drug expense and diagnostic expense for NS;CRT decision tree was used to establish a case combination model for NS.All studies in the paper were done by SPSS22.0.Results: 1.From 2013 to 2016,there were 2,399 patients with NS in Lanzhou,including 1,433 males and 966 females.The average age of hospitalized patients was(34.96±23.36)years old,and the patients were mostly concentrated in the young and middle-aged.2.The hospitalization days for NS was relatively stable and the average length of hospital stay was(10.98±6.73)days;the hospitalization expenses showed an upward trend and the average hospitalization cost was(11910.99±15723.95)yuan.3.The results of grey correlation analysis showed that the internal composition ofhospitalization expenses was as follows: drug expenses,diagnosis fee,medical service fee,treatment fee,nursing fee,consumables fee,adn other fees.The results of degree of structure variation showed that the impact of each individual cost on the hospitalization expenses of NS from the largest to the smallest in order of drug fee,diagnosis fee,treatment fee,consumables fee,medical service fee,nursing fee,and other fee.4.From the results of multiple linear regression analysis,hospitalization days,complications or concomitant symptoms and treatment methods have an impact on the total hospitalization costs,drug costs and diagnostic costs;the number of hospitalizations,surgery,and admissions way have influence on the total hospitalization expenses and diagnostic costs;age only affected the total cost of hospitalization and the payment method only affected the drug costs.6.A case-combination model was established for the hospitalization expenses of NS by classification and regression tree,and the model,fitted well.By calculating the case combination index,the cost efficiency index and the time efficiency index,it was found that the hospitals had different treatment effects for NS.Conclusions: 1.Reduce the financial burden of hospitalized patients with NS,and focusing on children aged 14 and below and elderly people aged 60 and over.2.Among the individual expenses of patients,the drug and diagnostic costs account for relatively high,the proportion of medical service fees and nursing fees is relatively small,so the structure of hospitalization expenses is unreasonable and should be properly regulated.3.The number of hospital days is positively correlated with the hospitalization expenses,reducing the number of invalid hospital days,which can effectively reduce the hospitalization expenses of patients.4.Medicare payment can reduce the patient's drug expenditure,and thus achieve the purpose of controlling hospitalization expenses.5.The results of the case combination study showed that the grouping was more reasonable,but further optimization was needed,and it is necessary to focus on the excess patients.6.All hospitals should maintain their advantages and improve their vulnerability to promote the further development of hospital medical capabilities.