Study On The Composition Of Hospitalization Expenses And Its Influencing Factors In The Treatment Of Lung Cancer Patients With TCM In Northeast China

ObjectiveTaking the composition of hospitalization expenses of lung cancer patients in Northeast China as an example,using the data of the first page of medical records of Chinese medicine analyze the influencing factors of hospitalization expenses of lung cancer patients and evaluate the changes in the expenses related to the cost of hospitalization in the treatment of hospitalization expenses.Then this paper will provide a reference for economic policy formulation.Methods1.The data comes from the data warehouse of the TCM Data Center of China Academy of Chinese Medical Sciences.The data of the in-patient medical records of patients with lung cancer in 45 hospitals in Northeast China during 2015-2018 were extracted.The collected indicators include patient demographic information and hospitalization information.,diagnostic information,treatment information and cost information.Then using the logic check method and logical fill method to sort out the data.2.Using descriptive analysis analyze the composition of the demographic information,hospitalization information,diagnostic information and treatment information of lung cancer patients.Then using descriptive analysis analyze the composition and changes of hospitalization expenses.3.Define the hospitalization expenses of lung cancer patients as dependent variables,And define gender,age,occupation,marriage,hospital grade,hospital type,admission route,hospitalization method,medical payment method,hospitalization days,ICD-10 code,main disease of Chinese medicine,whether to combine other diseases,treatment categories,hospital Chinese medicine preparations,TCM diagnosis and treatment equipment,TCM diagnosis and treatment techniques,and dialectical protection as independent variables.Using the quantile regression model analyze the influencing factors of hospitalization expenses for lung cancer patients,when the quantile is 0.15,0.25.0.50,0.75,0.90.Results1.Though the inclusion and exclusion criteria of data,there were 12,770 cases for study.including 7785 males and 4.985 females,with a male to female ratio of 1.56:1.The average age was 66.47±10.64 years.Mainly,there were 12.443 patients from the top three hospitals.accounting for 97.44%.And the hospitals were mainly Chinese medicine general hospitals,with a total of 8,944 people,accounting for 70.04%.2.Study on the composition of hospitalization expenses for lung cancer patients in Northeast China:Among the medical payment methods of 12770 patients,the basic medical insurance for urban employees accounted for 58.49%,the basic medical insurance for urban residents accounted for 10.20%;the total self-pay accounted for 14.74%,the new rural cooperative medical care accounted for 9.30%.In the composition of hospitalization expenses,the drug costs(including Chinese medicine fees.Western medicine fees)accounted for the highest proportion of 52.01%,diagnostic fees accounted for 19.54%,comprehensive medical services accounted for 12.68%,treatment costs accounted for 6.79%,other expenses accounted for 5.49%,Chinese medicine expenses accounted for 1.44%,surgery costs accounted for 1.04%The analysis of the changes in the average cost of the projects with a cost ratio of more than 10%and the average cost of the Chinese medicine projects shows that the cost changes of the three consecutive years have found that the comprehensive medical service fee,diagnostic fee and Chinese medicine cost are increasing year by year,and the average annual growth rate They were 24.28%,17.03%,and 68.11%,respectively;the western medicine fee has been declining year by year since 2016;the Chinese medicine fee has been declining year by year since 20153.Quantile regression analysis of factors affecting hospitalization expenses:Define hospitalization expenses for lung cancer patients as dependent variables,gender,age,occupation,marriage,hospital grade,hospital type,admission route,hospitalization method,medical payment method,hospitalization The number of days,ICD-10 code,combined with other diseases,treatment categories,hospital Chinese medicine preparations,Chinese medicine diagnosis and treatment equipment,Chinese medicine diagnosis and treatment technology,and syndrome differentiation are defined as independent variables,and the cost-related data is divided into 0.15,0.25.0.50.0.75.The 0.90 conditional quantile was applied to the regression model analysis.The results showed that in the cost interval with a conditional quantile of 0.15,gender,marriage,hospital grade,hospital type,admission route,hospitalization method,medical payment method,hospitalization 11 indicators including time,treatment category,syndrome differentiation,and other diseases were statistically significant.Within the cost range of conditional quantile 0.25,gender,occupation,marriage,hospital grade,hospital type,Admission route,way of leaving hospital,medical payment method,hospitalization time,treatment category,syndrome differentiation,merger and other 12 indicators such as diseases,the internal classification comparison was statistically significant;in the cost rane of conditional quantile 0.50,gender,occupation,hospital grade,hospital type,admission route,hospitalization method,hospitalization time,treatment category,10 indicators including syndrome differentiation and other diseases were statistically significant.Within the cost range of 0.75,gender,occupation,marriage,hospital grade,hospital type.admission route,and hospitalization 11 indicators including mode,hospitalization time.treatment category,syndrome differentiation,and other diseases were statistically significant.Within the cost range of conditional quantile of 0.90,occupation,marriage,hospital grade,hospital type 11 indicators,such as admission,hospitalization,medical payment,hospitalization,treatment,syndrome differentiation,and other diseases,were statistically significant.Conclusion1.Through the analysis of the cost-related indicators in the front page of the TCM inpatients with lung cancer patients,it is found that the proportion of Chinese medicine expenses in the composition of hospitalization expenses for lung cancer patients is lower than that of western medicines,and it shows a trend of decreasing year by year.TCM projects include diagnosis of traditional Chinese medicine,acupuncture and moxibustion,Chinese medicine massage treatment,syndrome differentiation,Chinese medicine treatment,Chinese medicine bone injury,Chinese medicine anorectal treatment,and other expenses accounted for a relatively low proportion,it is recommended to increase the proportion of TCM applications in the future,play the role of traditional Chinese medicine treatment.2.The results of the quantile regression model showed that the main factors affecting the hospitalization expenses of patients with lung cancer were hospital grade,hospital type,hospitalization time,treatment category,and syndrome differentiation.Among them,the hospitalization type of hospitals with integrated Chinese and Western medicine hospitals.traditional Chinese medicine hospitals,and traditional Chinese medicine hospitals is lower than that of western medicine hospitals.The hospitalization cost of lung cancer patients with treatment category is lower than that of patients with treatments of Chinese or Western medicine or Western medicine.The hospitalization cost of lung cancer patients with Chinese and Western medicine is lower than that of Western medicine.The hospitalization cost of lung cancer patients who performed syndrome differentiation is lower than that of lung cancer patients who have not implemented syndrome differentiation.It is recommended to improve the participation of traditional Chinese medicine in the treatment of lung cancer in the future,and give full play to the role of traditional Chinese medicine in improving the body function,reducing complications,reducing the toxicity of radiotherapy and chemotherapy,improving the efficacy of radiotherapy and chemotherapy,and improving the quality of life of patients with lung cancer.To alleviate the economic burden of lung cancer patients.3.In the process of standardizing the front page of the inpatient medical records of Chinese medicine,this study found that the inpatient medical records were not standardized or missing.And there were also shortcomings in the Classification and codes of diseases and ZHENG of traditional chinese medicine that could not meet the clinical practice requirements and lack of openness.It is suggested that the quality control of the homepage of Chinese medicine inpatients should be strengthened in the future.At the same time,the governments should upate the Classification and codes of diseases and ZHENG of traditional chinese medicine in time to meet clinical needs,improve the openness and expandability of the code to adapt to the complex clinical environment and manage the hospital.And lay the foundation for scientific research using the front page of the medical record.