Research On The Hospitalization Expense And Hospitalization Days Of Kunming Medical University No.6Affiliated Hospital

Purpose:Through collected five styles cancer inpatients’ hospitalization expense and hospitalization days data of Kunming medical university No.6affiliated hospital,we make full understanding of the current situation of hospitalization expense and hospitalization days,and analysis the influencing factor of them.we can explore how to control hospitalization expense rationally and reduce hospitalization days effectively,and Put forward the proposal how to improve medical quality and make full use of medical resources.Method:This study about the cancer inpatients’ medical record information(The top five clinical mortality cancer) of Kunming medical university No.6affiliated hospital from January1,2009to November30,2012(the data collected on December,2012).The medical record information combine1892cancer inpatients(843lung cancer inpatients,338colorectal cancer inpatients,320liver cancer inpatients,306stomach cancer inpatients,85esophageal cancer inpatients).Through the medical record information,we can investigate the cancer inpatients’ basic information,medical insurance situation,hospitalization expense and so on.We use the medical record information to build a database by Excel.and analysis the data by SPSS,for example, descriptive analysis,single factor analysis(Nonparametric rank tests),multiple factors analysis(multiple linear regression).Through the results,we can find the influencing factors,and control them to make the hospitalization expense and hospitalization days balance. Result:1.Cancer inpatients’ basic situation: According to five styles cancer inpatients’ data,(1)Cancer inpatients’ types are in the majority with lung cancer(44.60%),Colorectal cancer secondly(17.90%);(2)Men’s proportion(70.8%) is higher than women’s proportion(29.2%);(3)Cancer inpatients’ age is between18and94,specially,mostly between40and80(89.70%),and the average age is60.20±12.23;(4)Cancer inpatients’ occupation is in the majority with planting farmers(39.30%),normal farmers secondly(17.10%);(5)Cancer inpatients’ medical insurance is given priority to with urban employed workers’ basic medical insurance(UEBMI)(32.20%),new cooperative medical system (NCMS)(18.80%) secondly;(6)Cancer inpatients1therapy methods are given priority to with Surgical therapy(61.80%),the other inpatients’ therapy method is Conservative treatment (38.20%);(7)Cancer inpatients’ number is increasing from2009(384people) to2012(844people).2. The analysis result of cancer inpatients’ hospitalization expense:(1)Hospitalization expense is composed of drug costs(combine traditional Chinese medicine and western medicine),treatment costs(combine diagnosis costs,treatment costs,blood transfusion costs,nursing costs,oxygen costs),checking costs(combine laboratory test costs,checking costs),surgery costs(surgery costs and anesthesia costs),bed costs,radiation treatment costs and other costs. We can find the proportion of drug is highest(51.30%),the treatment costs(19.80%) and checking costs (19.80%)secondly.Through χ2tests,the proportion of many type costs is significant difference(P<0.05).The drug costs and treatment costs accounted for70%of hospitalization expense;(2)Cancer inpatients’ hospitalization expense per person is10215.95yuan,and per day is844.33yuan;(3)Single factor analysis of hospitalization expense:Through nonparametric Kruskal-Wallis H tests, diverse age inpatients’ hospitalization expense is not significant difference(P>0.05);diverse occupation inpatients’ hospitalization expense is significant difference(P<0.05);diverse medical insurance inpatients’ hospitalization expense is significant difference(P<0.05);diverse therapy methods inpatients’ hospitalization expense is significant difference(P<0.05);diverse years inpatients’ hospitalization expense is not significant difference(P>0.05).(4)Multiple factors analysis of hospitalization expense:After the logarithmic transformation of the data,and through multiple linear regression,if hospitalization days,therapy methods,medical insurance change,hospitalization expense will change.The Standard partial regression coefficient of hospitalization days,therapy methods,medical insurance is0.612,-0.264,-0,110(P<0.05).3.The analysis result of cancer inpatients1hospitalization days:(1)The proportion of less than10days cancer inpatients is highest(34.30%),the proportion of between10and19days cancer inpatients secondly(31.50%).The proportion of less than20days cancer inpatients is about65%;(2)Cancer inpatients’ average length of stay is13.00days;(3)Single factor analysis of hospitalization days:Through nonparametric Kruskal-Wallis H tests, diverse age inpatients’ hospitalization days is not significant difference(P>0.05);diverse occupation inpatients’ hospitalization days is significant difference(P<0.05);diverse medical insurance inpatients’ hospitalization days is significant difference(P<0.05);diverse therapy methods inpatients’ hospitalization days is significant difference(P<0.05);diverse years inpatients’ hospitalization days is significant difference(P<0.05).(4)Multiple factors analysis of hospitalization days:After the logarithmic transformation of the data,and through multiple linear regression,if therapy methods,medical years,medical insurance change,hospitalization days will change.The Standard partial regression coefficient of therapy methods,medical years,medical insurance is-0.439,-0.279,-0,113(P<0.05).4,The correlation between hospitalization expense and hospitalization days:Through correlation tests,the Spearman correlation coefficient of hospitalization expense and hospitalization is0.860.It shows hospitalization expense and hospitalization days are positive correlation.Conclusion:(1) According to five styles cancer data,men’s proportion is higher than women’s proportion.Cancer inpatients are mostly Middle-aged people and the elderly, and young inpatients are increasing,we should strengthen the prevention work of suffering from cancer;(2)Planting farmers are main cancer inpatients according to five styles cancer data,we should strengthen the health education of preventing to suffer from cancer;(3)Cancer inpatients’ medical insurance types are in the majority with urban employed workers’ basic medical insurance(UEBMI), new cooperative medical system(NCMS),and other medical insurance.Medical insurance plays an important role in helping cancer inpatients to get medical services.(4)Cancer inpatients’ therapy methods are given priority to with Surgical therapy.(5)The influencing factors of hospitalization expense are hospitalization days,therapy methods,medical insurance and so on.If we can control these influencing factors,the medical costs will reduce;(6)The proportion of treatment costs and drug costs are so high that we should find the cause,and reduce unnecessary medical services;(6)The influencing factors of hospitalization days are therapy methods,treatment year,medical insurance and so on.If we can control these influencing factors,the hospitalization days will decrease.(7)The relationship of hospitalization expenses and hospitalization days is positive correlation.If we can find the perfect balance between them,we will make full use of medical resources. To find a new payment type which can reduce the hospitalization expenses and shorten hospitalization days is very necessary.Suggestion:(1)To accelerate the reform of the medical system and improve the medical insurance system;(2)To shorten average length of stay,and reduce hospitalization expense per person,so as to effectively control the growth of medical expense;(3) To reduce unnecessary medical services, and avoid excessive use of medical resources, for the purpose of reducing hospitalization costs;(4) To use drugs rationally and reduce drug costs;(5)To draw lessons from foreign experience to optimize medical expense payment system, and establish China model DRGs payment systems gradually.