Study On The Current Status,Changing Trend And Influencing Factors Of Injury Treatment Costs In Gansu Province

Objective:This study analyzes the basic cost of treatment for patients injured in2018 in Gansu Province based on the"A System of Health Accounts 2011"(SHA2011).And to explore the trend of direct financial burden of injury to hospitalized patients in2014 to 2018,based on the 2018 survey data of hospitalized patients with injuries,using Radial Basis Function(RBF)Neural Network Model and Support Vector Machine(SVM)Model based on K-means clustering to explore the influencing factors of injury hospitalization expenses,and provide important data support and scientific and reasonable decision-making for relevant departments to formulate targeted injury prevention strategies,determine reasonable funding plans,and effectively control the rapid growth of injury treatment.Methods:According to the accounting framework of SHA 2011,using top-down accounting methods and macro-statistics and data collected from on-site surveys,the cost of treating injuries in Gansu Province is analyzed from four aspects:funding sources,institutional flows,service functions and beneficiary populations,all of which are collated in Excel 2019.Data apportionment accounting is used by STATA 14.0,and single-factor ANOVA,?~2 test,Pearson correlation analysis and Spearman rank correlation analysis of direct economic sharing of injury patients,2018 injury hospitalization data obtained from the field survey,single-factor analysis,RBF neural network model and SVM model based on K-means cluster analysis analyze the main factors affecting injury hospitalization cost,all data were built in SPSS 26.0 and analyzed as a single factor,and models were built in SPSS Modeler 18.0 for influence factor analysis.Results:1.In 2018,the cost of injury treatment in Gansu Province reached 4.194billion yuan.From a funding point of view,public financing accounted for 39.87%and household health expenditure accounted for 52.11%.From the institutional flow,75.01%of the cost occurred in the general hospital,followed by the central hospital,while the grass-roots institutions only 1.94%.Hospitalization costs accounted for 81.41%of the cost of injury treatment,the first three areas of injury with the highest costs were lower limbs,head and shoulders and upper limbs.2.From 2014 to 2018,the average male-to-female ratio of injured patients was1.56.The proportion of lower extremity injuries was highest in 5 years.Male head injuries accounted for the highest number of injuries;hospitalized patients aged 40 to64 were the most hospitalized with injuries.The main hospitals for patients are general hospitals and traditional Chinese hospitals,which account for 66.74%and 27.47%of all injured inpatients.The highest number of patients in municipal and county hospitals,accounting for 33.43%and 29.84%,respectively.During the five years,53.05%of inpatients paid medical expenses at their own expense,followed by the insurance of urban and rural residents.3.The average hospitalization cost of injury cases increased from 5,943.35 yuan in 2014 to 6,089.44 yuan in 2018,with an average growth rate of 0.61%,and the average daily hospitalization cost decreased from 728.45 yuan in 2014 to 690.52 yuan in 2018.The average rate of decline was 1.33%.The average number of hospital days increased from 8.16 days in 2014 to 8.82 days in 2018,with an average growth rate of 1.96%,and the cost of surgery increased with years,with an average growth rate of 21.59%.4.RBF Neural Network Model and SVM model analyzed the length of hospital stay,the level of institution synod and whether surgery had the greatest impact on injury hospitalization costs.The analytical prediction accuracy of The SVM model was higher than that of the BRF neural network model,and the prediction accuracy of the two models were 85.21%and 79.80%,respectively.Conclusions:1.The distribution of medical resources in Gansu Province is uneven,the response capacity of primary medical institutions is weak,the proportion of family health expenditure is relatively high,and the channels for health financing are single.It is suggested that the government should construct a reasonable financing model,constantly improve the basic medical security system covering the whole population,increase the coverage of all kinds of medical insurance,and further improve the universal health insurance system.2.Males and people over the age of 40 are at high risk of injury.Head and lower limb injuries are the sites where injuries occur more frequently.The prevention and control of injuries should be targeted at high-risk groups and vulnerable sites.3.The direct financial burden of injury hospitalization has increased over the years.The average hospitalization days and the average hospitalization costs were positively correlated with the years.The average growth rate of surgery costs was higher than 20%,and the direct financial burden of injury to hospitalized patients was heavier.Medical institutions should strictly implement the policy of zero drug rate,eliminate drug rebates,reduce drug charges,and implement a single-disease limit system,so as to reduce unreasonable medical costs.4.The length of hospital stays,the level of the institution and the availability of surgery are the most important factors affecting the cost of injury hospitalization.By implementing clinical path management,reducing unnecessary hospital days,improving the skills and professional ethics of medical staff,reducing unnecessary examination,prescribing and surgery,the treatment process will be more standardized and systematic.5.Injury can be prevented,from the government,medical and health institutions and individuals three levels,the development of scientific and reasonable medical expenses control strategy,can reduce the injury of economic losses and disease burden to a certain extent.