Analysis Of Disease Composition And Cost Of Elderly Hospitalized Patients In Kunming From 2016 To 2019

Objectives:To analyze the basic situation,disease spectrum distribution,hospitalization cost composition and changing trend of elderly hospitalized patients in Kunming from 2016 to 2019,and study the composition of major diseases affecting the health of the elderly,the composition of hospitalization service expenses and their service utilization in various hospitals.It will provide support for Yunnan Province to optimize the allocation of elderly health service resources,improve the elderly health service system,improve the level of medical security for the elderly,promote healthy aging,and actively respond to population aging.Methods:The Orcal database was established by using the homepage data of inpatient medical records of general hospitals and specialized hospitals in Kunming from 2016 to 2019,and the information of elderly inpatients aged 60 and above with household registration in Kunming was extracted and imported into SPSS 26 for statistical analysis.Descriptive analysis was carried out for the type of inpatient hospital,system disease composition,single disease distribution,multi-disease comorbidity,chronic disease composition,hospitalization expenses,etc.The measurement data were described by means±standard deviation,and variance analysis was used to compare differences;enumeration data The frequency and composition ratio were expressed,and the differences were compared using theX²test.Multiple linear regression was used to conduct multivariate analysis for the actual length of hospital stay and total hospital expenses.At the same time,in order to ensure the comparability of hospitalization expenses between different years,the hospitalization expenses were discounted with the Kunming Consumer Price Index（CPI）.Results:1.From 2016 to 2019,there were 1,009,190 elderly inpatients in Kunming,and the number of inpatients increased year by year(X_trend²=895322.614,P<0.001).In the past four years,the proportion of male inpatients was higher than that of females,and elderly inpatients aged 60-84 accounted for 90%of all elderly inpatients,hospitalization is mainly concentrated in public hospitals.2.From 2016 to 2019,the average hospitalization days of elderly inpatients in Kunming decreased year by year.The average hospitalization days in 2019 were 10.08 days,a decrease of 0.92 days compared with 2016.The average hospitalization days of males in each year were higher than that of females,and the average hospitalization days of elderly inpatients aged 75-94 increased with age.From the perspective of different hospitals,the average length of stay in tertiary hospitals is the highest,and the average stay in public hospitals is higher than that in private hospitals.From the results of multivariate analysis,occupation,medical payment method,marital status,age,gender,and surgical grade all had significant effects on the actual length of hospital stay.3.From 2016 to 2019,the top five systemic diseases of elderly hospitalized patients in Kunming were:circulatory system,respiratory system,digestive system,musculoskeletal system and connective tissue,and eye and adnexal diseases,the proportion of the top five system diseases reached nearly 70%.4.From 2016 to 2019,the average prevalence of elderly hospitalized patients in Kunming was 4.92±2.21,and the average prevalence of males was higher than that of females,and the average prevalence increased with age.5.From 2016 to 2019,82.88%of elderly inpatients in Kunming suffered from chronic diseases,the proportion of male inpatients with chronic diseases was higher than that of females,and the proportion of elderly inpatients aged 60-79 with chronic diseases increased with age;The top seven chronic diseases are:stroke,COPD,coronary heart disease,hypertension,tumor,diabetes,and senile cataract,accounting for 48.31%of the total chronic diseases.6.From 2016 to2019,the total hospitalization expenses of elderly inpatients in Kunming were 2.133billion yuan,2.596 billion yuan,2.865 billion yuan,and 2.671 billion yuan respectively after discounting.The average medical expenses of inpatients showed a downward trend after discounting.In 2019,the average medical expenses of inpatients were 9796.05 yuan,a decrease of 742.23 yuan or 7.04%compared with2016.The average medical expenses of male inpatients are higher than that of females,and the average medical expenses of inpatients of all ages show an increasing trend with the increase of age.The composition of the average medical expenses of inpatients are composed of the highest cost of drugs,the second of diagnosis,and the lowest of rehabilitation.7.The results of multivariate analysis of hospitalization expenses showed that the actual hospitalization days,surgical grade,occupation,age,medical payment method,gender,and marital status all had significant effects on hospitalization expenses.Conclusions:1.The total number of hospitalizations of elderly patients has increased,and the service needs of elderly people of different ages and genders are different.The utilization of hospitalization services for the elderly is mainly concentrated in public hospitals,and their average hospitalization days are not much different from that of the whole population.2.The distribution of systemic diseases in elderly hospitalized patients shows regional characteristics.Chronic diseases have become the main diseases affecting the health of the elderly,and there is a common occurrence of multiple diseases.3.Elderly inpatients have a heavier burden of disease,with medicines,consumables,and treatment expenses still accounting for a relatively high proportion,and rehabilitation expenses accounting for the lowest.The cost of hospitalization in the elderly is affected by many factors.