Study On Accounting And Projection Of Curative Expenditure On CCVD In Xinjiang Province

Objective:The overall goal of this study is to establish a cost accounting system for the current curative expenditure(CCE)of cardiovascular and cerebrovascular diseases(CCVD)based on System of Health Accounts2011(SHA2011)and the actual situation of Xinjiang.To provide data support for the accurate formulation of policies for the prevention and treatment of CCVD.method: Based on SHA2011,the total amount allocation is carried out by "top-down" method,and the CCE of CCVD in Xinjiang was analyzed : finance,institutions and the beneficiary population(age,sex and disease distribution);factor analysis are conducted for inpatient costs of CCVD in 2018,and on this basis,path analysis is carried out the CCE of CCVD in 2030 is predicted based on the component model by using statistical yearbook data and health service survey data of Xinjiang.result:1.In 2018,the CCE of CCVD in Xinjiang was 9.513 billion yuan.According to service function,inpatient CCE accounted for 70.09%,outpatient CCE accounted for 29.91%;according to institution type,89.47% of the CCE occurred in hospitals,followed by primary medical and health institutions,accounting for 8.91%;according to financing method,public finance accounted for 70.51%.2.From the perspective of population benefit,the top three age distribution of CCVD were 65-69 years old,60-64 years old and 50-54 years old,accounting for 13.12%,12.72% and 12.01% respectively;the CCE of men accounted for 52.80%,and the outpatient and inpatient CCE were higher than that of women;the top three diseases of CCVD were primary hypertension,coronary heart disease and cerebral infarction accounted for 32.16%,30.63% and 9.27% respectively;primary hypertension accounted for 51.39% of outpatient treatment;coronary heart disease accounted for 31.27% of hospitalization treatment.3.In 115031 cases of hospitalized patients with CCVD,the proportion of male patients is higher,the average hospitalization per time of male was 5894.06 yuan,and female was 4914.28 yuan;patients over 60 years old accounted for the highest proportion,53.37%,and the highest average hospitalization cost of age group was over 60 years old(5548.04 yuan);most of patients were coronary heart disease,primary hypertension and cerebral infarction,accounting for 70.70%.The top three diseases with average hospitalization cost per time were cerebral hemorrhage,cerebral thrombosis and cerebral embolism,with the amount of 10432.70 yuan,10216.92 yuan and 8799.94 yuan respectively;the number of patients from 1to 10 days was the most,accounting for 76.40%;the highest cost of patients was more than 31 days,accounting for 49079.66 yuan;the proportion of patients with medical insurance for urban and rural residents was the most,The highest hospital cost was the urban employees’ medical insurance patients,which was 6404.14 yuan;the number of hospitalized cases at county(District)level and below accounted for a relatively high proportion,which was 44.52%.The average hospitalization cost of provincial medical institutions was the highest,and the county(District)level and below was the lowest,which were20078.34 yuan and 4486.92 yuan respectively.4.The top five factors for CCVD were the level of medical institutions,the days of hospitalization,surgery,the type of medical institutions and age.5.The CCE of hypertension,coronary heart disease and cerebrovascular disease in Xinjiang will further increase rapidly.It is estimated that the total CCE of hypertension,coronary heart disease and cerebrovascular disease will reach 14.169 billion yuan by 2025 and 28.298 billion yuan by 2030.Conclusion:1.The medical resources of CCVD in Xinjiang are mainly concentrated in hospitals,and the medical service ability of primary medical institutions is relatively weak;the financing mode is mainly public financing,and the expenditure burden of outpatient patients is heavy.2.The elderly over 60 years old consume more medical resources and are the high-risk group of CCVD;primary hypertension,coronary heart disease and cerebral infarction are the key prevention and control diseases of CCVD.3.The level of medical institutions,the days of hospitalization,surgery,the type of medical institutions and age are the main factors that affect the treatment costs of inpatients.4.The CCE of hypertension,coronary heart disease and cerebrovascular disease will increase rapidly in the future.