Study On The Change Of Inpatient Cost Structure And Influencing Factors Of Tuberculosis Patients In A Specialized Hospital In Shenyang From 2017 To 2019

ObjectiveThrough the investigation of the data of hospitalization expenses of tuberculosis patients in a specialized hospital in Shenyang from 2017 to 2019,the change trend and structural changes of hospitalization expenses of tuberculosis patients in three years were understood,the relationship between the basic conditions of patients and disease factors and hospitalization expenses was analyzed,and the influencing factors of hospitalization expenses were discussed.This paper provides the basis for the development of tuberculosis medical expenses control measures,and puts forward feasible suggestions for further reducing the economic burden of tuberculosis patients and improving the management system of tuberculosis medical expenses control.MethodsPatients admitted to a specialized hospital in Shenyang from 2017 to 2019 due to tuberculosis were selected and their hospitalization costs were studied.The content includes the demographic characteristics of patients,hospitalization costs and the composition of various costs,disease factors,medical insurance payment types and other information.SPSS22.0 was used to analyze the data after Excel 2003.Descriptive studies were used to observe the general situation of hospitalization expenses in three years.Structural change analysis and grey correlation analysis were used to study the changes in the internal composition of hospitalization expenses.The test level α=0.05.P<0.05 was statistically significant.1.Changes in hospitalization expenses from 2017 to 2019: a total of 4,983 patients with tuberculosis were hospitalized in a specialized hospital in Shenyang during the three years,and the number of inpatients showed an overall decreasing trend,the hospitalization expenses showed an increasing trend,and the number of days of hospitalization showed an increasing trend.Each individual cost rose sharply in 2018,and stayed flat or fell slightly in 2019.2.Composition and structural changes of hospitalization expenses from 2017 to2019: During the three years,drug costs and examination costs accounted for a relatively high proportion,with negative changes in drug costs and examination costs,positive changes in treatment costs and nursing costs,and great structural changes in 2017-2018.The contribution rate of examination fee to the change of hospitalization cost structure was the highest during 2017-2018,which was 37.88%,and the contribution rate of medical material fee to the change of hospitalization cost structure was the highest during 2018-2019,which was 33.27%.3.Grey correlation analysis: The results show that the top five related expenses from2017 to 2019 are drug costs,other costs,treatment costs,examination costs and bed costs.In 2017,the top three correlation coefficients were drug cost,bed cost and treatment cost.In 2018,the top three correlation coefficients were drug cost,medical material cost and treatment cost.In 2019,the top three correlation coefficients were drug costs,examination costs and treatment costs.The correlation coefficients of drug costs were the largest in all three years.4.Analysis of the influencing factors of hospitalization expenses: different gender,age group,region,registered residence location,tuberculosis type,sputum smear test,treatment type,whether to be hospitalized for the first time,and payment method of medical insurance were all influencing factors of hospitalization expenses,with statistical significance(P<0.05).There were statistically significant differences in total hospitalization cost,drug cost,examination cost,treatment cost,bed cost,nursing costResults and medical material cost between self-paid patients and medical insurance paying patients(P<0.05).Conclusions1.Total hospitalization costs for tuberculosis patients increased significantly in2018 and decreased slightly in 2019 compared to 2018.The cost of medicine,examination and treatment are the main expenses of inpatients.2.The structure of hospitalization expenses changed greatly from 2017 to 2019.The cost of medicine and examination showed negative change,while the cost of treatment and nursing showed positive change.3.The influencing factors of hospitalization cost were gender,age,region,registered residence,tuberculosis type,sputum smear test,treatment type,whether to be hospitalized for the first time,and medical insurance payment method.The marginal mean value of self-paid patients is higher than that of medical insurance paying patients,especially in drug cost,examination cost and treatment cost.