Research On The Change Trend Of Post-medical Expenditure Cost Structure In Chongqing Based On Compositional Data GM(1,1)Model

Objective: To explore the changes in the total medical expenses and the average cost of medical items after the implementation of the medical reform in Chongqing in 2017,and to evaluate the applicability and rationality of the GM(1,1)model for the medical cost structure data,and to use the model prediction values.Compare with the actual medical expenses after medical reform to comprehensively evaluate the effect of medical reform.Methods: Based on the implementation time of medical reform in Chongqing(September 9,2017),the medical expenses data of inpatients in a hospital in the previous year of Chongqing medical reform and half a year after medical reform were collected.In order to rule out the impact of different seasonal diseases on medical expenses,compare the average cost before and after the medical reform in the same season.After the medical expenses composition data of the year before the medical reform was converted into the logarithmic logarithm of the component data,the GM(1,1)model and the component residual GM(1,1)model were established,and the residual accuracy method was used to calculate the model accuracy.Evaluation.The model was used to predict the composition of the four-month medical expenses without medical reform,and to compare with the actual medical expenses after medical reform.Finally,the effect of medical reform is evaluated in combination with the average cost and cost composition.Results: The total cost of hospitalization after medical reform was increased compared with that before the medical reform,with a range of 5.29%.After the medical reform,the average drug fee and the second-level radiological examination fee were significantly lower than those before the medical reform,with a decrease of 7.62% and 7.79%,respectively.The average bed fee,the second-average surgery fee and the second-average care fee showed an upward trend after the reform.The compositional data GM(1,1)model and the component data residual GM(1,1)model established by the original composition ratio data all have an accuracy of 86% or more.And after the final reduction,the composition is compared with the predicted value of the data and the real cost.The average relative residual is not more than 5%,and the prediction accuracy is high.Comparing the extrapolation prediction results with the actual medical reform cost,it is found that due to the implementation of the medical reform policy,the proportion of medicines and inspections is significantly lower than that without medical reform;the proportion of bed fees is higher than that without medical reform;The upward trend,and the proportion will exceed the unhealed situation;the material cost is higher than the unhealed situation,and is about 3% higher.Conclusion: The GM(1,1)model of the component data and the residual GM(1,1)model are reasonable and applicable for the time series prediction of the medical cost structure,and can be extrapolated.The burden of medication for inpatients and the burden of inspection of large equipment have been greatly improved,and the value of medical personnel's labor value has been improved.The control of material fees should be the focus of medical reform to reduce medical expenses,and avoid the phenomenon of medical expenses being transferred to materials.