Analysis Of The Composition Of Medical Payment Of Discharged Patients From A Hospital In Tai’an From 2014 To 2016

Research BackgroundWith the rapid economic development,human health needs are increasing,while excessive medical expenses increase the suppression of human health care needs.Medical system reform is a major problem in the world today,China is also constantly exploring and growing.In recent years,"difficult and expensive to see a doctor "has become the main reason for the growing tension between doctors and patients,and also become the focus of the current medical and health system reform.In order to solve the contradiction between doctors and patients,China has introduced a series of measures,medical reform is the reform of all the top priority.Research purposesIn this study,the medical payment in a hospital during 2014-2016 years of discharged patients constitute analyzed,designed to continuously improve the hospital management measures to improve its medical technology and health care quality.Through medical payment analysis can make medical institutions achieve reasonable management,reasonable control fees,to promote the medical insurance institutions to develop a reasonable payment way.Encourage people to participate in commercial insurance,ease the economic pressure,and hope that through data support for local health insurance agencies to provide a reference.Materials and MethodsData from a hospital 2014-2016 in electronic medical records system of the medical record.A retrospective of collected medical record data,export medical payment from the electronic medical record system,medical record,the sex,age,primary diagnosis_ICD,length of hospital stay,patient sources,total hospital costs,drugs,away from the hospital the way,surgery,critical,infect,Section 13 indicators,a total of 140,698 patients discharged from exporting information,after excluding 228 missing and incorrect information discharged patients records,140,470 discharged patients were analyzed.Use EXCEL2010 to establish a database and data processing and classification.The age,sex,length of hospital stay,patient’s origin,disease composition,total cost of hospitalization and medical expenses were classified according to medical methods.The age,sex,length of hospital stay,patient origin,disease constitution,hospitalization Total cost,medical expenses.The general characteristics of the patient,the number of days of hospitalization and the cost of hospitalization were analyzed,and the Pareto analysis was used to analyze the disease.Multivariate linear regression was used to analyze the cost of hospitalization for basic medical insurance.variance analysis for normally distributed data,skewed distribution of the data Kruskal-Wallis test,to compare the rate of χ2 test(two-sided test).EXCEL2010 was used to analyze a variety of rates,using SPSS20.0 statistical software for various tests and analysis.The main result1.Excluding the missing information and error cases,2014-2016 had a total of 140,470 patients discharged from hospital visitors,including basic medical insurance patients 102,954 people,accounting for 73.29%of discharged patients.2.In the medical payment structure,urban and rural residents medical insurance,up to 56.40 percent,secondly,insurance for urban workers,accounting for 21.34 percent,the smallest proportion of commercial health insurance,only 0.48%.3.The hospital discharged patients,the male to female ratio is 1.01:1.In the age group of 0-10 years old and 61-70-year-old patient was discharged a high proportion for 20.78%,16.29%respectively.4.Source of patients in the hospital is mainly Tai’an City,representing 93.41%,other cities in the province and other provinces accounted for only 6.59%.Sources from the patient’s medical payment situation,Tai’an City medical payment,mainly in urban and rural residents medical insurance,accounting for 58.46 percent,other cities in the province and other provinces are mainly private patient.5.The disease accounted hospital in a hospital in Class A factor of 76.78%of patients discharged from hospital.A class factor diseases of the circulatory system diseases;health status and contact with the factors affecting health institutions;respiratory diseases;pregnancy,childbirth and postpartum;certain other consequences of injuries,poisoning and external causes;digestive disorders;cancer;genitourinary system disease.A class-factorial disease is the focus of clinical work in a hospital.6.2014 annual discharge an average length of stay of 10.13 days in 2015,the hospital’s average length of stay of 9.93 days,the hospital’s 2016 average length of stay 9.15 days.Grouping seen from the number of days of hospitalization,hospital patients over 30 days accounted for 2.8%,while the average length of stay was48.88 days,over 30 days of a hospital patient is the main targets to be monitored.7.The hospital in 2014-2016 years of discharged patients per capita cost of 10,466.11 yuan,accounting for 35.10%drug in 2015 is higher than the 3-year average of 2014 and 2016,less than 3-year average,while the per capita cost in 2016,drugs accounted Than the decline significantly.8.2014 years-2016 years of basic medical insurance patients showing a decreasing trend,basic medical insurance patients,especially in the fourth quarter than other quarters.Basic medical insurance patients reimburse the higher proportion of the disease for injury,poisoning and some other consequences of external causes,affecting health status and exposure to health care factors,reimbursement of the lower proportion of the disease is pregnancy,childbirth and puerperium origin Some of the circumstances of life.9.carried out by the basic medical hospitalization expenses insurance Multiple linear regression analy sis showed that the 11 included in the analysis of the factors affecting their contributions to the cost of hospitalization were:length of stay,whether surgery,consumables fees,medicines,age,critically ill,Leave the way,whether the infection,sex,address,whether to transfer subjects.Conclusion and Suggestion1.In view of the basic medical insurance for low-level,wide coverage characteristics,proposing to strengthen the commercial medical insurance.2.For release to accelerate aging and two-child policy,the relevant departments should strengthen the elderly,children and the elderly maternal concern.3.In view of the average length of stay,proposing to promote the grading system of diagnosis and treatment,the promotion of day surgery.4.In view of the cost of per capita,accounting for controlled drugs,it recommended the introduction of clinical pathways,to carry out a single DRGs,and gradually transition to DGRs.5.Faced with the pressure of the basic medical insurance fund,to strengthen health care management,health care costs to develop early warning line departments.6.The development of the hospital long term,to increase hospital information management,improve management efficiency.7.Hospitals focus on education training,regulate medical practices,to better serve patients.