A Study On Medical Consumables Cost Based On Single Disease

With the development of medical technology,medical consumables are playing an increasingly important role in clinical practice.However,it also causes the rapid increase of medical costs.One of the important objectives of the new healthcare reform is to control the rapid rise of patients’ medical expenses and reduce medical costs.Meanwhile,the new reform brought some new thoughts and objectives on the linkage reform of health care,medical insurance and medicine,and the guidance to use the payment system of single disease and single disease clinic pathways,etc.This study focus on the general changes of the surgical patients’ medical consumables expenses,to explore the regularity of medical consumables costs of the surgical patients with single disease by investigating several common single diseases and surgeries,to conclude the current situation and characteristics of consumables costs of surgical patients with different diagnostic diseases based on the standard of the medical service charges and the limitation of price charge for single disease,which lay the basis to set norms and standards for medical consumables use in single disease clinical pathways.Objectives: To reveal the annual changes of patients’ mean costs of per surgery and their mean costs of medical consumables by studying the annual overall changes in medical consumables costs of surgical patients.To figure out the annual changes in costs of medical consumables for single disease and single surgery;and the effect of different diagnosis and surgical procedures on the consumables costs for similar diseases.Methods: Surgical patients’ information during 2016 to 2018 was collected from hospital information system(HIS),including each patient’s ID,age,length of hospital stay,diagnosis,major surgery and details of charges.Annualize the mean costs of consumables and the total hospitalization fee of each patient.Several common single diseases and surgeries are selected and classified for study,mainly analyzed the differences of consumables costs of the patients with different diagnosis/surgeries,including the annual differences and the differences among different diagnosis in the same category.The Shapiro-Wilk method was used to test the normality of the group n<1000,and kolmogorov-smirnova method was used to test the normality of the group n>1000.When comparing the cost of medical consumables among multiple groups,anova is used when the sample normality and homogeneity of variance are satisfied.Kruskal-wallis H test is adopted for those samples that do not meet the normal distribution or homogeneity of variance.When comparing the cost of medical consumables between two groups,T test of two independent samples is adopted to meet the sample normality.Wilxocon rank sum test of two independent samples was adopted for those samples that did not meet the normal distribution of samples.P < 0.05 for the difference is statistically significant.Results: From 2016 to 2018,the total mean costs of per surgery increased first and then decreased.The mean costs of medical consumables increased year by year.There exists a statistical difference in pair comparison between 2016 and 2018 for patients’ costs of medical consumables in surgeries of such a single disease as cesarean section,bilateral tonsillectomy,open appendectomy,open cholecystectomy,minimally invasive cholecystectomy,cataract phacoemulsification(left eye and right eye)and other surgical methods.The P values as follows: cesarean section(P<0.0001);bilateral tonsil excision(tonsil hypertrophy and chronic tonsillitis)(P<0.0001);open appendectomy(P<0.0001),minimal invasive appendectomy(P=0.0428);open appendectomy for acute purulent appendicitis(P<0.0001),open appendectomy for acute appendicitis(P<0.0001);open cholecystectomy(P<0.0001),minimal invasive cholecystectomy(P<0.0001),open turn minimal invasive cholecystectomy(P=0.2124);cholecystectomy for gallstone with chronic cholecystitis(P<0.0001),cholecystectomy for gallstone with actual cholecystitis(P=0.0011),cholecystectomy for gallbladder polypi(P<0.0001),cholecystectomy for gallstone(P=0.2145);phacoemulsification in left and right eye(P<0.0001).In 2018,tonsil hypertrophy and diagnosis of chronic tonsillitis two groups of patients with bilateral tonsillectomy between medical consumables costs there is no statistical difference(P = 0.1164);Acute suppurative appendicitis and acute appendicitis diagnosis of appendectomy(open)surgery in patients with medical consumables cost does not exist between the statistical difference(P = 0.0949),laparoscopic gallbladder surgery surgery patients between different diagnosis group in medical consumables costs there is no statistical difference(P > 0.05),different surgical site(right and left eye)between the cost of medical consumables in patients with cataract phaco surgery there is no statistical difference(P = 0.7244).Conclusion: The costs of medical consumables accounts for a major proportion in the surgical patients’ hospitalization fee.Compared with the price limit standards of medical insurance for single disease in Chongqing,the patients with single disease expend more money on medical consumables in surgery,hospitals bear a high cost of medical consumables.Knowing the differences in the costs of medical consumables between patients with different diagnosis but same surgical procedures will help us to carry out standardized management for clinical use of medical consumables in single disease,single disease clinical pathways in hospitals and appropriate use and management of medical consumables.It also offers a basis for further healthcare reform to control the patients’ healthcare expenses and to reduce the medical consumables costs of hospital.