Analysis Of Influencing Factors Of Direct Hospitalization Expenses Of Tuberculosis Patients In A Third-grade A Hospital In Nanchang City

Objective:By analyzing the medical record information and hospitalization expenses of tuberculosis patients discharged from a 3 Armour hospital in Nanchang from 2016 to2018,the main influencing factors of hospitalization expenses of tuberculosis patients in the hospital were discussed.It provides a theoretical basis for the hospital to reasonably control fees and reduce the economic burden of patients,as well as a constructive reference for relevant administrative departments to formulate effective policies.Methods:Extracted from the hospital electronic medical record system and HIS 2016-2018hospital first diagnosis for the basic situation of tuberculosis patients?gender,age,marital status,place of residence,occupation,type of ginseng?,disease conditions?type of treatment,sputum microscopy results,with other diseases,hospitalization days,year of admission?and hospitalization expenses?including cost breakdown?information,through descriptive statistics method for patients with all kinds of information of the frequency distribution and composition ratio.The non-parametric rank sum test was used for single factor analysis of the factors affecting hospital expenses and a multiple linear regression model was established for multi-factor analysis.Results:1.Results of basic information analysis of the patients:among the 3640 patients,the average age was 48.27±19.41 years;Male patients?72.17%?were more than female patients?27.83%?.Farmers accounted for39.45%of patients,other personnel?unemployed or housework?accounted for 27.53%;The majority of married patients,accounting for 79.15%of the total;51.52%of the patients lived in xinjian district,nanchang county and xihu district.The majority of the insured patients were urban and rural residents,with 2593 cases?71.24%?.2.Analysis results of patients'diseases:among the 3640 patients,most of them were newly treated?80.63%?.Results of sputum microscopy were negative in 78.60%of the patients.Patients without other diseases accounted for 70.74%of the total cases.The mean length of stay was 15.65±6.79 days;The largest number of patients were hospitalized in 2018,with 1,259.3.Analysis of hospitalization expenses of patients showed that the average hospitalization expenses of patients were 14941.67±8562.93 yuan,and the proportion of each itemized expense in hospitalization expenses were:drug expenses?38.31%?,inspection and inspection expenses?31.09%?,treatment expenses?15.99%?,materials expenses?8.04%?,nursing expenses?2.50%?and other expenses?4.05%?,respecti-vely.4.Univariate analysis results of hospitalization expenses:age,occupation,marital status,type of treatment,sputum microscopic examination results,combined with other diseases,length of stay,year of admission and drug cost were 9 factors with statistically significant differences in hospitalization expenses?P<0.05?.5.Results of multivariate analysis of hospitalization costs:drug costs,hospitalization days,combination of other diseases,sputum microscopy results and year of admission were the main factors affecting hospitalization costs of patients with tuberculosis.The multiple linear regression equation is:Y=3.687+3.540E-5X₁+0.061X₂+0.022X₇+0.024X₈+0.048X₉Conclusion:1.Middle-aged and elderly patients and urban and rural residents covered by medical insurance are the main groups with high burden of tuberculosis;2.Drug cost,length of stay,combined with other diseases,sputum microscopic examination results and year of admission were the main factors affecting the hospitalization cost of pulmonary tuberculosis patients;3.Reducing drug cost remains the key to control the cost;4.Hospital management should be strengthened to further improve the level of diagnosis and treatment,reduce the number of days in hospital and standardize medical behavior.