Analysis Of Hospital Costs Structure And Related Factors Of Three Kinds Of Single Disease Operated Patients

In recent years, the cost for medicinal treatment increases sharply in every country, and the speed of its growth has been faster than that of Gross National Product (GNP) and Price index. China's health management is also facing a serious problem that the cost for medicinal treatment increases too fast. It has become focus and main difficulty to control the cost for medicinal treatment reasonably. Therefore,it is not only the common purpose of government, medical organization and medical insurance organization but also the anxious wish of civilians to find an effective means to ensure the development of medical high and new-technology and improve medical quality, increase the efficiency of the medical work, control the medical costs, and reduce medical expense. Among them,the key to approach this objective , ensure the efficient use of medical resources and control the irrational increase of medical expenses lies in adopting an appropriate form of payment for medical expenses.Fee for service items, one form of payment for medical expenses, which is being used in china, is one of the main reasons which stimulates the growth of medical expenses and also is originator of excessive medical treatment. In recent years, in order to control excessive increase of medical expenses, lighten the burden on patients and make effective use of health resources, make hospital charges open, transparent and convenient for monitoring, the form of single disease payment has been discussed in more and more hospitals. It is essential but difficult to develop a suitable prospective payment system, which takes disease as the leading factor and correlative factors of disease as reference,in the light of realities of China. One vital precondition for this job is to clarify the present condition and structural factors of medical costs to provide evidences for the government's policy. This paper relied on practical fees in operated patients of three kinds of single diseases in a certain hospital at the level of Grade III as a argumentation, on the base of consulting experts and summarizing the success of rest experimental units in other cities, by descriptive and Mann-Whitney Test, Kruskal-Wallis Test, stepwise regression analysis to these three kinds of single diseases'data. The aim of this study is to supply hospital managers with some concrete control measures of hospitalization fees of single diseases,provide basic data for management of medical costs of single diseases and medical insurance reform in Ji Lin province, and provide health administrative organization with foundation for decision of establishing a Single Sort Disease Payment System in accordance with the Ji Lin actual case and carry out"payment based on the diseases categories"step by step in Ji Lin province.The results show that among average hospitalization expenses of three kinds of single disease operated patients, medicine expenses account for the tiptop proportion, and the second is treatment expenses; that though the influencing factor to the three kinds of single diseases operated patients is not completely identical,hospitalization days as a disease's characteristic and ages as a social and economic characteristic are both main factors influencing hospitalization expenses. Among influencing factors of hospitalization expenses of patients, who receive pituitary gland tumor operation, the main influencing factor is postoperative hospital stay, but its influence on hospitalization expenses also via the hospitalization days indirectly. It explains that there is something unreasonable in the compensation model of medical expense, that the composition of hospitalization expense is unreasonable, that the consumption compensation of living labor is less than that of materialized labor, that the hospital's technical advantages aren't embodied completely, that the hospital's technical level can be improved further, and that reducing hospitalization number has been an important way to effectively control the growth of medical expense.From three aspects, including the subject of medical and health service, namely supplier of medical and health service (medical institution at all levels), the demander (patient), and payment manner of the medical expenses, this research analyzed factors affecting single disease payment in hospitals. The factors mainly included payment manner of the medical expenses which could affect how the supplier of medical and health service chose medical and health service, ideas of consumer receiving services, and payment manner of the medical expenses and providers'motivation. And it analyzed the reasons leading to irrationality of hospitalization medical fees'structure targeting the imperfects of nowadays system and management that exited in the system of charge for service items, purposed that the hospital should prescribe reasonably, examine reasonably and use materials reasonably on the basis of adjustment of Medical Personnel's Labor Service's income, should offer high-quality, low-price medical and health service, create good social benefit, improve doctor-patient trust degree, establish good doctor-patient relationship, reduce unnecessary medical resource mutual promotion, form good circulation, open a path that hospital benefit can be in accordance with patient interests. Only by acting as above can we have a double-win future and control the growth of medical expense effectively. By analyzing advantages and disadvantages to single disease payment, the writer purposes that it is the beneficial to attempt to reform nowadays system of charge for service items in our country and it can be seen as the makeshift to relieve the burden of expensive medical cost. The positive significances of single disease payment in effectively controlling unreasonably rise of medical expense and limiting excessive medical treatment are beyond doubt. But in the concrete operating process, there are many that need to be improved and perfected. The hospital should adjust appropriately the present management mode and policy, so that they can meet challenges of single disease payment, which is a new reform of payment manner of the medical expenses.