A Three Level Of First-class Hospital Senile Cataract Surgery Single Disease Cost Construction And Management

Objective(1) Through to a hospital in single disease cost impact factor analysis and cost intervention study. Constructing single disease average cost. Find out the total cost in senile cataract in the cost of the majority, analyzed the main factors of hospitalization fees for hospital medical treatment cost control to provide the reference.(2) Find single disease hospital expenses inner relationship of scale, explore the influence of the patient in the cost of the controlled factor into controlled factor of the effective way, for the patient in the lower costs to provide the reference.(3) Combined with pay medical insurance, analyzes a single disease hospital limits (set) amount of medical treatment insurance settlement limitations and institutions on the rationality of the amount of the hospital. For the medical health management departments and medical insurance agency to develop single disease provide basis for standard digital, explore to establish an appropriate medical treatment charge pays way, avoid medical waste of resources.Research methods(1) The literature researchThrough the network retrieval, the related literature at home and abroad material, explore single disease cost accounting and cost management research progress in China, the experience of the pilot, analyzed the main documents from CNKI, ten thousand party data and MEDLINE.(2) Experts consultation methodFinancial managers, health to the hospital management experts and medical personnel for consultation, from single disease cost accounting and management of Angle, to the contents of the senile cataract definition. Through the investigation of expert of the medical information and economic information collection, master the cost structure and share the content of the project.(3) Scene investigation methodThe retrospective investigation method, according to the international disease classification method (ICD-10-CM), from Shanxi Province three level of first-class eye specialist hospital a backstage obtaining HIS senile cataract (in phacoemulsification+iol implantation) in January2010-March2012as the research object case data, and the corresponding collection of records in hospital home page and hospitalization expense settlement material, senile cataract diseases of cost accounting analysis.(4) Statistical analysis methodThe basic information of the medical insurance in hospital patients:age, gender structure of statistics to general description.through the frequency distribution and frequency distribution table analysis charge of be in hospital, the length of days of distribution characteristics. With the multiple regression analysis method, Considering the characteristics of the patients, the disease features two sociology class variables, the medical insurance cost, be in hospital patient in the days of influencing factors.Results(1) Senile cataract patients in hospital in total cost, consumables treatment and operation large proportion, followed by examination cost and expenses for medicine, which supplies the treatments and operation, artificial crystal and viscoelastic agent proportion is the largest. Therefore, patients generally choose a high price import artificial crystal and viscoelastic agent is in hospital in total fee increases the direct reason.(2) According to the patient age, is divided into four groups respectively, the different age groups of the patient in the cost analysis, producing senile cataract patients more concentrated in the70-79years old this age; By gender, the male patients in hospital costs slightly higher than female patients, this is due to systemic disease than men with more than women with, and therefore to charge of be in hospital increase; More than90years old group than any other age group inspection fee; Consumables treatment with age difference gradually declined increase; Increase with age is higher expenses.(3) According to the cataract department cost, income and patients in hospital the analysis of the cost on average, and concludes that the department cost increase, the disease to average cost will surely increase, department income reduced:Variable costs of department cost larger proportion, including special consumables and variable cost of larger proportion.(4)Tthe single blind contrast method after intervention, special material fee is reduced, and at the same time the day in hospital reduce, the patient in the lower cost, performance of medical cost reduction.Conclusion(1)Mmedical institutions and patients should try choosing domestic surgical supplies, and medical personnel should guide according to the actual situation of the patients to choose suitable surgical supplies, reduce the charge of be in hospital.(2) Single disease cost accounting management, strict implementation of clinical pathway in the foundation, standardizing medical activities, control department special consumables operation, examination and expenses for medicine, such ability reduce disease in costs at the same time, reduce the cost of department, so as to increase revenue department, promote development department.(3) Single disease cost accounting and scientific management, need hospital staff and departments of attention and coordination.