Analysis Of The Constitutions Of Medical Expenses For Hypertension And Diabetes Patients And Their Related Factors In Jiayuguan City

Research Background Hypertension is a common cardiovascular disease,arterial hypertension as the main feature,is a serious and chronic disease menacing human health.World prevalence of hypertension increased year by year since it is a serious danger to human health.Diabetes(diabetes mellitus,DM)is a metabolic disorder caused by a variety of reasons,leading to a diversity of chronic organ damage,dysfunction and failure.World Health Organization(WHO)has classified four types of diabetes.Long-term diabetes,time span,complications with high morbidity and mortality,but also seriously affect the development of other descent such as hypertension,chronic heart disease,which are in the family of a heavy burden on society.Taking reference to the report of the WHO from its official website published in 2012;1.1 million cases of deaths were caused by hypertension which is about 48.6% of the global top ten causes of death in 2012,since 2000 there had been remarked an increase of 35.7% of 800,000 death cases.Hypertension in developed countries is the second largest risk factor for health danger,resulting in 10.9% of the disease burden.Hypertension has been ranked as number 8 in terms of risk factors for health in developing countries,with a total disability-adjusted life per year of 3.0% DALYs.The 2013 global summary hypertension WHO showed that in 2008,the economic burden of cardiovascular disease in the world caused a total economic burden of 3.76 billion yuan,accounting for 51.64 percent of chronic non-transmissible diseases.Diabetes caused 1.5 million cases of deaths,accounting for 2.7% of the total global top ten causes of death,which increased by 50 percent over one million cases of deaths from 2000 to 2012.WHO released data shows that: In 2008,adults over the age of 25 have the prevalence of diabetes of about 10%.The economic burden of disease caused by diabetes worldwide was 0.42 billion yuan,accounting for 5.9% of chronic non-transmissible disease.In recent years,due to the public health awareness,the whole worldwide societies have shown a rapid increase investment in the field of health care,health care costs in the world showed a trend of rapid growth,almost more than economic growth or income growth.During the past 30 years of china's reform and opening up,rapid medical expenses grow rapidly,with an the annual growth rate of 18%,twice the average GDP growth rate(9.7%),which has brought an enormous economic pressure to the country.ObjectivesSuccessfulness of the analysis of hypertension and diabetes information regarding the hospitalization costs from three hospitals;the Jiugang Hospital,Jiayuguan city first People's Hospital and Jiayuguan city Second People's Hospital during a period from 2005 to 2014.Second,we need to understand the hypertension and diabetes hospital costs constitution and economic burden associated Situation from Jiayuguan city,Jiayuguan control of hypertension and diabetes health care costs,reduction of the burden of disease and economic pressure over residents of Jiayuguan City,in order to provide more factual basis for further improvement of hypertension and diabetes prevention and treatment programs,ultimately Jiayuguan City health resources reasonable configuration,effectively carry out and providing a scientific basis about health services.Methods All data in this study was collected from hospitalized patient in three large public hospitals of Jiayuguan City;Jiugang hospital,Jiayuguan City First People's Hospital,and Jiayuguan City Second People's Hospital.I recorded Patients' medical information in order to display the first diagnosis of "hypertension" and "diabetes" as the research objective;surveying data about hypertension and diabetes medical record of patients with an age of greater than or equal to 18 years old.Sampling information has been done by gathering and grouping recorded data from the three hospitals discharge archives of patients' medical records.Preliminary screening was first done using Excel in order to retain useful indicators,and then export data files to be screened and analyzed in depth using SPSS19.0 statistical analysis software for data organization and analysis.The basic condition of the patient,the composition of the patient medical cost trends for each part of the medical expenses of the descriptive analysis method using rank sum test for 10-years expense of hospitalization differences were compared(significance level a = 0.05),patient medical expenses methods factors influencing multiple linear regression(test level a = 0.05).In this study,the analysis in determining variable key consideration in patients with several types of variables are closely related to medical expenses,such as age,sex,and length of stay of patients,and so on.Results 1.Analysis of hospitalization expenses for hypertension PatientsIn 2005-2014 the average per capita hospitalization expenses had a small rise in 2006 for hyp ertension patients and in 2011,there was an overall declining,and a significantly decrease in 2014.Composition of hospital expenses for patients with hypertension had shown that: Drug costs accounted for 51.42% of total hospital costs per capita;examination fees accounted for 29.57% of total hospital expenses per capita;treatment costs per capita accounted for 7.89% of total hospital expenses.These constitute the three constituents ratios of total hospital expenses per capita.Drug costs and examination fees,the two charges add up to the proportion of total hospital costs per capita of more than 80%,of which the larger in proportion is the drug charges,where the drug costs in developed countries constitute between(5%~20%)and in developing countries average drug costs are higher and constitute between(15%~40%).Comparison between single factor analysis and multiple factor analysis results showed that;influence factors about hospital costs expenses per capita for patients with hypertension is higher for men more than for women during treatment period;where older patients spend more period of time in hospital,which allows the medical cost to be as high as possible.A drug cost for patients with hypertension reached a medicine proportion of 75.75%,but the cost of medicine overall has an upward trend.In 2014,the first time hypertension medicine costs exceeded the medicine costs per capita and reached 1525.54 yuan for patients with hypertension;in last 10 years,traditional Chinese medicine drug costs accounted a relatively stable change remaining between 40%~60%.Per capita drug costs during 2011-2014 showed a downward trend,but during a period between 2005-2013,the proportion of hypertension inspection fees showed an overall upward trend for patients with hypertension;in 2014,the inspection fees for patients with hypertension had a drastic decline.But,treatment per capita cost for patients with hypertension in 2012 decreased significantly.2.Analysis for diabetes hospitalization expenses Diabetes per capita hospital costs in 2005-2014 years maintained at 3000~4000 yuan,per capita hospital costs calculated the discounted value comparison: 2012-2014 per capita hospital costs overall downward trend,2008-2012 there were minor fluctuations occur only in a sudden drop in 2014 and a minimum of cost.Combination of univariate and multivariate analysis results: age of the patient and hospital costs were positively correlated,medical costs mean higher consumption of older,higher cost compared to men women during treatment spent;the longer average length of stay,medical costs are higher.During 2011,the diabetes drugs cost accounting for 84.28 percent in both China and Western countries,then after 2011,Western medicine cost per capita had decreased,and diabetes drugs in China continued to increase.During the 9 years period from 2005 to 2013,examination fees for diabetics in Jiayuguan showed an overall upward trend except in 2014.2007 was remarked by a trend decrease,but the years since 2008 until May 2014 showed an upward trend of diabetes drug and medical costs,and since May 2014 a remarkable downward trend has emerged.Conclusions 1.Between 2005 and 2014,hypertension and diabetes per capita hospital costs in Jiayuguan City fluctuated slightly for each year,but there had been an overall downward trend in 2014.Jiayuguan City results show a large floating change in recent years,where the disease prevention and control has been made.2.In Jiayuguan hypertension and diabetes per capita hospital costs,more than half of the total cost is covered by drug costs and hospitalization expenses,indicating that the main source of drugs is a major part of the economic burden for patients,reasonable and effective control of drugs control for hospital costs should be rising the burden on the patient's priority.3.For hospitalized patients,the hypertension and diabetes cost impact factors were found to be higher for male and older people due to the long-stay of patients in hospital,also health related departments should start from this point of view to adopt more beneficial interventions policy and Suggestions for the best prevention of hypertension and diabetes in the next few years,and provide key indicators to effectively control hypertension and diabetes hospital costs which is a surge in the labor of health contribution in Jiayuguan City.