Analysis Of Medical Expenses For Inpatients With Dominant Diseases Of Traditional Chinese Medicine Based On Medical Insurance Payment

Objective: Due to the different treatment methods of traditional Chinese medicine and western medicine,there will inevitably be differences between the payment standard and the actual service cost,which will have a significant impact on the operation of the hospital.Therefore,strengthening the research on medical expenses and medical insurance payment of dominant diseases of traditional Chinese medicine can not only understand the differences in medical services,but also play an important role in promoting the medical insurance payment system of dominant diseases of traditional Chinese medicine.We selected the dominant diseases of traditional Chinese medicine(neck pain and low back pain)as an example to analyze,understand the clinical diagnosis and treatment of patients,use statistical methods to analyze the hospitalization costs and influencing factors of patients,and deeply discuss and analyze the differences between the actual costs of patients and the DRG payment standards,so as to provide reference for the reform of medical insurance payment for the dominant diseases of traditional Chinese medicine.Methods: This study used the policy research method to understand the current situation of DRG reform in China.To understand the current situation of hospitalization expenses of patients with traditional Chinese medicine and the difference between hospitalization expenses of patients with western medicine through literature research,and to understand the current situation of medical insurance payment methods;Select the information on the first page of the medical records of inpatients who were discharged from the rehabilitation department of a combined traditional Chinese and western medicine hospital in Dalian from 2018 to 2021 and were diagnosed with neck pain and low back pain by traditional Chinese medicine for empirical research,and apply SPSS22.0 software carries out single factor analysis and multiple linear regression on the data to analyze the influencing factors of hospitalization expenses,and applies Mplus Version 8.3 to establish a structural equation model to further analyze the factors affecting hospitalization expenses.Make reasonable discussion and suggestions on the data results.Qualitative interviews were conducted to understand the medical insurance payment policy,the treatment methods of integrated traditional Chinese and western medicine,and the patients’ feelings and health improvement.Refine the core ideas and build a theoretical framework.Results:1.There were 499 cases of neck arthralgia and 834 cases of low back pain.The average age of patients with cervical spondylosis is 54.38 ± 12.20 years old.The proportion of patients in the 50-59 age group reached 32.26%,which was the largest age group.Age of patients with low back pain(M=59,IQR=18).The proportion of patients in the 60-69 age group is 29.98%,which is the largest age group.The number of female patients was higher than that of male patients,with 65.53% and 64.87% of female patients of the two diseases respectively.Most patients have spouses.Most of the patients are basic medical insurance for urban workers.2.The average length of stay of patients with arthralgia was 11.81 days(M=12,IQR=4),and the average length of stay of patients with low back pain was 11.79 days(M=12,IQR=4).The proportion of hospitalization days between 1-13 days for patients with two diseases is the largest.From 2018 to 2021,the average hospitalization days showed a downward trend.More than 35% of patients were hospitalized more than twice.The majority of patients are outpatient and inpatient.More than 40% of the patients are accompanied by complications,more than half of the patients have used traditional Chinese medicine preparations,traditional Chinese medicine diagnosis and treatment equipment and traditional Chinese medicine diagnosis and treatment technology in medical institutions,and most of the patients have implemented dialectical nursing.3.The average value of the total hospitalization cost of patients with Xiang Bi is9426.09 ± 2563.93 yuan.The total cost of hospitalization for patients with low back pain(M=9385.06,IQR=3779.74).The total cost of hospitalization for each time of the two diseases is generally rising.Traditional Chinese medicine treatment expenses account for the largest proportion,followed by diagnosis expenses,and other expenses account for the smallest proportion.4.According to the results of univariate analysis,female patients in different gender groups spent more than male patients in hospital.The hospitalization cost of patients aged80 and above is the highest.Patients aged 60-69 with low back pain have the highest cost.With the increase of hospitalization days,the average hospitalization cost per time also shows an upward trend.There were significant differences between groups in gender,age,spouse,length of stay,complication,use of TCM diagnosis and treatment technology and different discharge years(P<0.05).The patients with low back pain use traditional Chinese medicine diagnosis and treatment equipment,use traditional Chinese medicine preparations of medical institutions and dialectics(P<0.05).5.According to the analysis results of multiple linear regression equation,the factors that affect the total hospitalization expenses of patients with TBI include gender,age,length of stay,whether there are complications,and year of discharge(P.The factors affecting the total hospitalization expenses of patients with low back pain include gender,age,length of stay,whether there are complications,use of traditional Chinese medicine preparations in medical institutions,use of traditional Chinese medicine diagnosis and treatment technology,marriage and discharge year(P.According to the results of structural equation model,it can be seen that exogenous variables have a significant impact on hospital expenses,and there is a partial intermediary effect,indicating that exogenous variables indirectly affect hospital expenses through TCM management.Conclusion: The influencing factors of hospitalization expenses of patients with arthralgia in this study are gender,age,length of stay,presence or absence of comorbidities,and year of discharge.The influencing factors of hospitalization expenses of patients with low back pain are gender,age,length of stay,presence or absence of comorbidities,use of traditional Chinese medicine preparations in medical institutions,use of traditional Chinese medicine diagnosis and treatment technology,marriage,and year of discharge.The exogenous variables have a significant impact on the hospitalization expenses,and indirectly affect the hospitalization expenses through TCM management.This study shows that the treatment methods of traditional Chinese medicine and western medicine are different,and the hospitalization expenses and cost structure are also very different.Therefore,we should build a payment mode of integrated traditional Chinese and western medicine to improve the quality and efficiency of medical services.Based on value,scientifically formulate the clinical path of traditional Chinese and western medicine.Actively carry out the three-level prevention of diseases,do a good job in disease publicity and health education,and reduce the incidence rate of diseases.So as to effectively reduce the medical cost of patients and the expenditure of medical insurance fund.