Analysis On Hospitalization Expense Of Tuberculosis Patients With Diabetes And Its Influencing Factors

Objective: In this study,the data of hospitalization expenses of TB patients with type 2 diabetes mellitus in a hospital from 2012 to 2019 were used to understand the change trend and internal structure,and to explore the main influencing factors.This study provides a scientific basis for optimizing the internal structure of hospitalization expenses,controlling medical expenses reasonably and taking relevant measures to reduce the economic burden of patients.Methods: The data of patients with type 2 diabetes mellitus who were discharged from hospital from January 1,2012 to December 31,2019 were selected.The basic characteristics of frequency and composition comparison were used for descriptive statistical analysis.The median and interquartile spacing were used to describe the concentration and dispersion trends of inpatient days and inpatient expenses.Using the growth rate index to analyze the change trend of hospitalization expenses,and using the structural change analysis method to analyze the composition change of each part of expenses.In single factor analysis,Mann Whitney u-rank sum test was used to analyze the two classified variables,Kruskal Wallis h-rank sum test was used to analyze the multi classified variables,and Spearman rank correlation test was used to analyze the correlation between variables.In order to further explore the main influencing factors of hospitalization cost of TB patients with type 2 diabetes mellitus,multiple stepwise linear regression was used to fit the recursive model in path analysis.SPSS 24.0 software package was used for all statistical analysis.The inspection standard is 0.05.Result: 1.From 2012 to 2019,there were 4290 TB inpatients with type 2 diabetes mellitus,86.71% of them were male,13.29% were female,and the average age was 56.50 ± 12.458 years old.The registered permanent residence of inpatients is mainly in the municipal district(86.01%).The main mode of payment is medical insurance for urban residents(61.82%).39.37% of the patients were smear positive tuberculosis.83.89% of the patients had other diseases.38.55% of the patients were hospitalized for the time.2.When it is not adjusted according to CPI,the total hospitalization expenses and per capita hospitalization expenses show an increasing trend;after the adjustment,the total hospitalization expenses show an increasing trend,while the per capita hospitalization expenses show a slow decreasing trend.Among the individual costs,the per capita costs of comprehensive medical services,treatment and medical materials are on the rise as a whole,while the per capita costs of diagnosis and medicine are on the decline.3.According to the size of the composition ratio,the individual expenses are medicine expenses,diagnosis expenses,comprehensive medical services expenses,medical materials expenses,treatment expenses and other expenses.During 2012-2019,the internal structure of hospitalization expenses changed significantly,with an average annual structural change of 3.50%.Among them,the expenses of comprehensive medical services and medical materials showed a positive change,while the expenses of diagnosis,medicine expenses,cost of blood and other expenses showed a negative change.According to the contribution rate of structural change,the main categories of hospitalization expenses are comprehensive medical services expenses,diagnosis expenses,medicine expenses,medical materials expenses,etc.4.According to the magnitude of the total effect,the influencing factors of hospitalization expenses are in turn: hospitalization days,medical insurance for urban residents,smear positive tuberculosis,first hospitalization,commercial insurance,etc.Conclusion: 1.From 2012 to 2019,the majority of TB patients with type 2 diabetes were male,mainly in the 36-65 age group.The early two-way screening,prevention and treatment of the two diseases should be carried out,and the management of the high-risk group and the confirmed patients should be strengthened to improve the prevention and treatment effect of the disease.2.The per capita hospitalization cost of TB patients with type 2 diabetes kept at a high level.In order to reduce the heavy economic burden caused by antituberculosis treatment,we should take all factors into consideration to further improve the tuberculosis control system and compensation mechanism.3.The proportion of medicine cost and diagnosis cost is on the high side,while the proportion of comprehensive medical service cost is on the low side.The main categories that affect the change of internal structure of hospitalization expenses include comprehensive medical services,medicine expenses and diagnosis expenses.The value of medical staff's technical labor has been paid more and more attention,but it is still necessary to continue to optimize the internal cost of hospitalization,reasonably adjust the proportion of medicine and diagnosis cost,improve the charging standard of medical service technical service items,strengthen health education and policy publicity,improve the treatment compliance of patients,so as to reduce the economic burden of patients.4.The main influencing factors of hospitalization expenses are hospitalization days,medical insurance for urban residents,smear positive tuberculosis,first hospitalization,commercial insurance,etc.Under the condition of ensuring the quality of diagnosis and treatment service,we should mainly reduce the invalid hospitalization time,and take into account various strategies and measures to effectively control the medical expenses.