An Examination Of Hospital Costs And The Elements That Affect Those Suffering From Heart Failure In Shenyang

ObjectiveThrough the analysis of the electronic medical records of inpatients with heart failure(heartfailure,HF)in two third-class hospitals in Shenyang within three years,to understand the characteristics of patients with heart failure and the composition of hospitalization expenses,and to explore the factors affecting the hospitalization expenses of patients with heart failure,so as to provide effective policy reference for the control of hospitalization expenses of patients with heart failure and the rational allocation and utilization of medical and health resources.MethodsThe electronic medical records of inpatients with heart failure admitted in two third-class hospitals in Shenyang from September 2018 to September 2021 were collected,and the first-time patients were selected.Record the patient’s medical record information(including age,sex,hospitalization days,discharge department,etc.),diagnostic information(heart failure type and NYHA cardiac function classification diagnosis),medical insurance type(provincial insurance staff,city insurance staff,city insurance residents)and detailed information of hospitalization expenses(including hospitalization disposal fee,heating fee,nursing fee,blood transfusion fee,air conditioning fee,bed fee,diagnosis fee,etc.).Microsoft Excel2019 software and SPSS23.0 software were used to input and summarize the collected data,and nonparametric rank sum test was used for univariate analysis of hospitalization expenses and length of stay.At the same time,the dimensions of each component of hospitalization expenses of patients with heart failure were reduced,and the variable information was extracted by principal component analysis.Finally,the load relationship after rotation was obtained by variance maximization method,and the common factor was determined.In order to better understand the hospitalization costs of patients with heart failure.Taking the disease information,diagnostic information and type of medical insurance of patients with heart failure as independent variables,the common factors and hospitalization costs extracted by principal component analysis as dependent variables,through multiple linear regression analysis,to study the influencing factors of hospitalization costs of patients with heart failure,to better explain these factors,and to provide patients with a more effective treatment plan.The test level is α = 0.05.Amos21.0 was used to draw the path map of factors affecting hospitalization costs in patients with heart failure.Results1.A total of 1085 patients with heart failure were included in this study,of which 51.4% were male patients,48.6% were female patients in the 71-90 age group,and the least in the > 90 age group.The most patients were hospitalized for 8-14 days,accounting for 71.6%,accounting for 49.8%.Only 46(4.2%)patients underwent surgery.For the type of medical insurance,the city insurance has the largest number of employees,accounting for 84.5%.2.The total hospitalization expenses of patients with heart failure reached12460.7 yuan,of which drugs accounted for the highest proportion,reaching 27.87%,followed by laboratory fees and disposal fees,accounting for 19.33% and 17.12%,respectively.These three expenses constitute 64.32% of the hospitalization expenses of patients with heart failure.3.Factor analysis extracted a total of three common factors,factor 1 drug service factor;factor 2 treatment Eisai factor;factor 3 ultrasonic examination factor,the variance contribution rate was 40.629%,13.313%,10.405% respectively,and the cumulative variance contribution rate was 64.347%.4.Univariate analysis showed that age,length of stay,NYHA cardiac function grade and whether or not operation affected the hospitalization cost of patients with heart failure,while age,NYHA cardiac function classification and type of medical insurance affected the hospitalization days of patients with heart failure.5.The multiple linear regression model adjusted the influence of confounding factors,suggesting that there were significant differences in hospitalization days,NYHA cardiac function classification and hospitalization costs between patients with heart failure and patients with heart failure.There were significant differences in age,NYHA cardiac function classification,hospitalization days between municipal insurance workers and patients with heart failure.Conclusion1.Drug cost is the main component of hospitalization expenses for patients with heart failure.2.The increase of hospitalization expenses of patients with heart failure is mainly affected by public factors such as drug services,therapeutic materials and ultrasound examination,among which drug service is the most important factor,which may lead to a significant increase in costs.3.Hospitalization days,NYHA cardiac function classification and whether to perform surgery are the main factors affecting the hospitalization cost of patients with heart failure,among which the hospitalization days are affected by age,NYHA cardiac function classification and municipal insurance workers.