Analysis Of Hospital Costs Structure And Related Factors Of Single Diseases In A Grade Ⅲ-A Hospital In Yunnan Provinces

Objectives:This research mainly studied Gallbladder stone with Chronic Cholecystitis hospitalization expenditure in a Grade III-A hospital in Yunnan procinces from 2008 to 2012.To analyze its composition and variation tendency. The major objective was to find the key factors influencing the hospitalization expenditure by single factor analysis and multiple stepwise regression analysis, then to take appropriate measures to control hospitalization expenditure according to these factors, and also to provide the policy suggestion and reference for the establishment and improvement of single disease management and control system.Methods:By the method of survey on the basic information of the 1445 patients medical records from 2008-2012 a Grade Ⅲ-A hospital in Yunnan provinces. Selecting Gallbladder stone with Chronic Cholecystitis disease according to the international classification of diseases (ICD10) method. Basic information in themedical record home page as the basis, investigating the patient’s disease characteristics, social characteristics, diagnosis and treatment quality indexes andproportion of hospitalization expenses. All the data was double-entered by Epidata and analyzed by SPSS statistical software package. Descriptive analysis, single factor analysis and multiple regression analysis was used, to investigate the effects of different factors control strategy on hospitalization expenses.Results and Discoveries:(1) In the past 5 years, Gallbladder stone with Chronic Cholecystitis expenditure presented a overall trend of increasing and the economic burden of disease became heavier, In 2012 the average hospitalization cost 9015.84 yuan. Medicine fees accounted for the highest proportion in the hospitalization expenses, followed by the operation fee. (2) It revealed that the structure of hospitalization expenditure was not reasonable and it was difficult to value the service and technique of medical workers. Medical fee, the average proportion as highly as 51.52%, took the biggest proportion of the hospitalization expenditure. (3)Length of stay was the most important factor influencing the hospitalization expenditure and the hospitalization expenditure continuously increased along with the prolonged hospital stay. (4) Single factor analysis showed that Medicare patients hospitalized costs less than at one’s own expenses patients (p< 0.05), the medical insurance system has important effect to control health care costs. (5)The analysis of single factor and multiple factors both revealed that hospitalization days, gender, age, surgery, past medical history, whether to have minor year of diagnosis, operative time, discharge, and outcome all influenced the hospitalization expenditure (p<0.05).Suggestions:Medicine fees and hospitalization days are the main factor affecting the hospitalization expenses of chronic cholecystitis with gall bladder calculi disease. It suggested that:Medical insurance institutions formulate reasonable price of single disease payment. In order to reduce medical costs, and reduce the economic burden, Single disease payment reform is necessary. Secondly, improve the basic drug system, in order to control the illogicality rise of drug expenditure. Thirdly, reduce hospitalization days in clinical pathway. What’s more, improve the basic medical insurance system, so as to improve the residents’ health care utilization. At last, strengthen management, and guide reasonable medical consumption.