Analysis On Disease Composition And Cost Of Inpatients In A3a Grade Hospital In Guangxi From 2017 To 2019

Objective To analyze and discuss the disease composition and cost of inpatients in a 3A grade hospital in Guangxi from 2017 to 2019,make clear the present situation and change of inpatient disease composition and cost.To provides decision basis for scientific management,rational planning,discipline development,promotion of medical and health supply construction,improvement of medical and health service level and optimization of cost structure,and effectively reduce the burden of disease.Methods The first page information of medical records of 155,590 inpatients in a 3A grade hospital in Guangxi from 2017 to 2019 was selected according to the ICD-10 standard.Retrospective study method was adopted,Excel was used for data preprocessing,and IBM SPSS23.0 was used for statistical analysis of patient information description.Chi-square test and T test were used to study the difference in disease composition of inpatients.Univariate analysis and multivariate linear regression analysis were performed on the influencing factors of average daily hospital expenses.Results The number of inpatients in the hospital increased by an average of6.53 percent per year from 2017 to 2019.The top five system diseases of inpatients were respiratory system diseases(11.22%),circulatory system diseases(11.06%),digestive system diseases(9.51%),pregnancy,childbirth and puerperium(9.19%),and urogenital system diseases(8.82%),accounting for49.79% of the total.The order of systematic diseases of inpatients were different in each season.The age of inpatients ranged from 0 to 102 years old,and patients over 36 years old accounted for 67.04% of the total.Respiratory diseases are the main diseases in patients aged 0-14,pregnancy,childbirth and puerperium in those aged 15-35,health status and contact with health-care institutions in those aged 36-64,and circulatory diseases in those aged over 65.The ratio of male to female inpatients was 103:100,and the top three systemic diseases of male inpatients were circulatory system diseases,respiratory system diseases and digestive system diseases.The top three systemic diseases of female inpatients were pregnancy,childbirth and puerperium,urogenital system diseases and respiratory system diseases.The number one disease among the retired,farmers and freelancers was circulatory disease.Pregnancy,childbirth,and puerperium rank first in all occupations except retirees,farmers,and freelancers.The average length of hospitalization of patients in this hospital was 8.94 days,mainly distributed from 1 to 20 days,showing an obvious skewed distribution.The top three systemic diseases with average length of hospitalization were tumor,injury,poisoning and some other consequences of external causes,and circulatory system diseases,with average length of hospitalization being 12.72 days,12.25 days and 11.21 days,respectively.The average length of stay during pregnancy,childbirth and puerperium was the shortest,at 3.52 days.Injuries,poisonings,and certain other consequences of external causes,tumors,and circulatory diseases had the highest number of patients with hospital stays longer than 30 days.The comparable hospitalization cost of the hospital increased year by year,with an annual growth rate of 13.66%;The proportion of reimbursement and compensation increased significantly from 40.11% in 2017 to 56.69% in 2019.The out-of-pocket amount of patients decreased significantly.Comparable price per time and average daily hospitalization cost showed an upward trend,the latter increased more than the former.There were statistically significant differences in gender,age,payment method,year of hospitalization,operation or not,and length of hospitalization.The results of multiple linear regression analysis showed that the five factors,age,operation,payment method,hospitalization days and hospitalization year,all had significant influence on the average daily hospitalization cost.Orthopedics,neurosurgery,intensive care medicine,oncology,and neurology were among the top five inpatient expenses in the hospital.The total expenses of diagnosis,western medicine and consumables accounted for78.76%;Comprehensive medical service fee and treatment cost accounted for13.98%.Conclusion Deepen the talent strategy,enhance the medical technology strength of the hospital,enhance the competitiveness of the hospital,and further enhance the regional influence;We should take the development route of strengthening hospitals with wisdom,improve patients’ satisfaction with medical treatment,increase the number of medical service objects and expand the service radius.Carry out health management to carry out personalized management of key diseases and key groups,apply the theory and technology of preventive medicine,combine with clinical medicine,reduce the incidence of high-risk groups and achieve disease prevention and control through the control of disease risk factors and the formation of disease state;By strengthening the refined management of clinical pathways and effectively controlling the length of hospital stay,the goal of reducing the burden of disease has been achieved.Strengthen the strength of respiratory system,circulatory system and other related departments,do a good job in the construction of key disciplines,and introduce scientific management mode to cope with the increasing proportion of inpatients with diseases of respiratory system,circulatory system,tumor,digestive system and other diseases.With market demand,positioning,hospital planning department for the three standards,adapt to the need of the society and face the disease changes,in academic assessment,accurate positioning,accurate configuration and development,quality and efficient hierarchical advantage weak department helping each other,to a key subject,driving the development of other departments,to achieve the coordinated development of floor of disciplinary good momentum.Promote the adjustment and optimization of medical expense structure,further reduce the drug proportion of medical expense,restrain the growth of consumable cost,make room,fully reflect the value of medical personnel’s technical labor service,make the expense structure rationalization,more in line with the direction of the new medical reform.