Study On The Trend Of Inpatient Cost And Related Factors Of Inpatients With Acute Simple Appendicitis

BackgroundWith the rapid development of socio-economic, our medical and health services got a great achievement. People’s health level improves gradually. But the medical and health system is not perfect. The obvious aspect is that the medical expenditure grows too fast and the service is not enough. The problem of "getting medical service is difficult and the expenditure is too high" is obvious which is needed to resolved.The increasing of the medical expenditure concerns the interests of people and gets the attention of all the society. How to decrease the length of stay and expenditures is the important problem for the government. In the critical period of the medical service reform, we are still faced with the problems of "getting medical service is difficult and the medical expenditure is too high" and so on, how to analyze and utilize the factor which can influence the medical expenditures, how to control the unreasonable growth, how to use the medical source reasonable and how to improve the medical service need us to carry out further study.AimsBased on the descriptive analysis aiming at acute appendicitis, the aim of the study is designed to analyze the inpatient cost growth trend and learn about the related factors on the inpatient cost, and provide the basic information to reduce the medical expenditure reasonably. MethodsThe retrospective study method was used to get the information of patients with appendicitis from2006to2011including the social demographic indicators, length of stay, expenditure for stay and the expenditure patterns And the literatures needed in the study mainly came from the CNKI Chinese full-text literature database, PSTP Chinese full-text literature database and Wan Fang Data, etc.Convert the expenditure of different date to the comparable prices with the price index over the different years and confirm the final data set, then do data processing and analyzing with SPSS. Analyze the general features and expenditure of patients with the general descriptive method, and analyze the expenditures of the acute appendicitis patients with variance analysis, t-test correlation test and multiple linear regression.Main Results1. The expenditures of the patients with appendicitis is increasing gradually, the average cost increased from4026.64in2006to4546.11in2011. In the expenditure pattern, the cost of drug takes the high range is about29.80%to42.10%. The examination expenditure increases year after year, it has increased to16.50%from8.78%. The technical expenditures such as diagnosis and surgery take the low relatively percent but the others are relatively high.2. The result of the expenditures and length of stay shows that the correlation index of Pearson is0.630,p=0.000.They are the positive linear relationship.3. The analysis of variance indicates that the patients’age, the year hospitalized, therapy method and different type of medical insurance influence the medical expenditure. The expenditure for staying in hospital increases with the age. The expenditures of cured patients are higher than the improved patients; the expenditures of operation patients are higher than the patients in conservative treatment; and the expenditures of the people having health insurance are higher than those at their own expense.4. Multiple regression analysis shows that the factors influence the expenditures including:length of stay, surgery or not, age, medical service method, outcome and the year for staying in hospital.Suggestions1. Reasonable drug use and control the ratio of medicine cost; 2. Reasonable inspection to avoid over-inspection and over-testing, to reduce the burden on patients;3. Perfecting the price index of technologies and drugs to change the status quo of price inversion to improve the technical service value of health care;4. Shortening the days of patients in hospital, to control the growth of hospitalization expenditures;5. The perfection of community health service system to satisfy the needs of residents and health services, decrease the medical expenditures;6. To strength the management of patients, and control the expenditures of medical insurance for urban workers patients;7. Enhancing the operational capacity of health care, strengthen the medical ethics education.