| Research BackgroundIn recent years, medcial fees has been increasing which is far above the growth rate of GDP over the same period and delivery costs is also increasing year by year. In 2005, the total cost of health care was 865.991 billion yuan, which was 4.73% of GDP. "China's total health expenditure report 2006" issued by Health Economic Research Institute of the Ministry of Health shows that from the year 1978 to 2005, the total cost of health was at an average annual growth rate of 11.47% which was slightly faster than the GDP growth. Three times of national health service survey shows that the average hospital delivery rate of urban and rural residents in China increased from 38.7 % in 1993 rose to 50.4% in 1998 and to 68.3% in 2003, of which the rate of caesarean section rose from 2.4% in 1993 to 6.1% in 1998 and 15.9% in 2003 respectively. With the fact, medcial delivery fees has become a social problem arousing much public concern in China. The issue of medcial delivery fees is directly related to whether pregnant woman and her family can afford it so that it affects that whether health care service can be used effectively.The Standard of medical service price such as operation fees, delivery fees, medical checkup fees and medical care fees which are made by Price Bureau in Shandong Province has not changed at all within these five years. It is beacause that the common people cannot afford to give birth to a child, so it's essential to control the delivery fees. Due to that delivery can be diagnosed clearly and easily cured, hospital birth is a fundamental and standard services. On the basis of analysis and researches of a three-level general hospital, the thesis analyzes the influencing factors and provide reference for the effective control of maternity medical fees.ObjectivesThrough the systematically analysis of maternity medical fees of a three-level general hospital from the year 2003 to 2007 and research the composition of hospital fees and their impact factors, the thesis provide reference for hospital administrators to use health resources more effectively, reduce health care costs and control the excessive growth of medical costs.MethodologyThis research uses survey methods to collect relevant information such as all cases of maternal hospitalization and cost of hospital deliveries related to a three-level general hospital from the year 2003 to 2007 and analyzes pregnant woman hospitalization basic information, maternity medical fees and the influence of medical fees. The statistical methods of the survey are descriptive analysis, multi-factor regression analysis and SPSS13.0 statistical software.Main FindingsThe main findings include: firstly, within five years, maternal average total cost of hospitalization was in an upward trend that 2007 is 1.38 times in 2003 ,of which treatment cost was increasing significantly that 2007 is 2.38 times in 2003. It is mainly related to the improvement of one-time equipment of infusion and the upgrade of dressing. Overmore, improvement of the technology of maternal and child custody is also increasing the cost of hospitalization. Secondly, the cost of hospital deliveries is closely related to the delivery mode that the cost of cesarean section is significantly higher than the cost of birth. Thirdly, the cost of hospital maternity care for pregnant women is closely related to the environmental requirements that hospital delivery in a higher price ward cost much than in a general ward. Fourthly, the cost of hospital deliveries has positively correlated relationship to the the number of days hospitalized that the longer length of stay, the higher the cost of hospital deliveries. Fifthly, the cost of hospital deliveries is related to the presence of pregnancy-related complications. Sixthly, multiple regression analysis shows that the impact of the cost of hospital delivery has a wide range of factors including delivery mode, the number of days hospitalized, pregnancy-related complications, ward-level and so on.ConclusionFirstly, the average and daily hospital fees of normal delivery are lower than the cesarean section. Secondly, the cost of hospital delivery is affected by many factors such as the increase in cesarean section rate, prices increasing, application of high-tech, improvement of health care demand and imperfect payment mechanism. Thirdly, drug costs is in a larger proportion in the cost of hospital delivery. Fourthly, the impact of the controlling of cesarean section rates in the way of paid by the disease or limit has been researched.Policy RecommendationsFirstly, to have reasonable indications for cesarean section and control the cesarean section rate. Secondly, to strengthen the pre-conception and pregnancy health and reduce the incidence of pregnancy complications and complications. Thirdly, during pregnancy and delivery, to enhance the health education and enhance maternal confidence in normal birth. Fourthly, to shorten the average length of stay effectively. Fifthly, to strictly control the use of a one-time items and reduce the medical equipment and a one-time price of medical consumables. Sixthly, to reduce the proportion of drug costs among the cost of hospital deliveries. Seventhly, to make policy, strengthen supervision and control the growth of hospital costs by relevant government departments. Eighthly, to implement clinical pathway management and implemente payment system by the disease or limit. |
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