Estimation Analysis On Curative Care Expenditure Of Respiratory Diseases In A Province In Central China Based On "System Of Health Accounts 2011"

Objective: This study analyzes the direct treatment costs of respiratory diseases in a central province of China in 2019,explain the distribution of medical expenses for respiratory diseases in a central province of China from different perspectives(the medical expenses of people of different ages;the differences in medical expenses of people in different regions;the flow of medical expenses of various types of medical institutions;whether the proportion of government health expenditure,voluntary medical insurance scheme,and personal or household health expenditure is reasonable),explore the main influencing factors of the expenses,and contact relevant policies according to the specific situation of a central province of China,Propose countermeasures to reduce the burden of medical expenses of patients and improve the accessibility of medical services.Method:In this study,the multi-stage stratified random sampling method was adopted to extract the outpatient and inpatient cost data of various health institutions at various levels in a certain province in central China in 2019.Based on the calculation principle of "SHA2011",the method of apportionment from total amount to individual case was adopted.Stata15.1 was used to clean and establish the database and calculate the treatment cost of respiratory diseases.To comprehensively understand the incidence of respiratory disease treatment costs from the aspects of service function,institutional distribution and beneficiary groups;In addition,the differences of respiratory system treatment costs in different regions of the province were analyzed and compared,and the main types of respiratory system diseases were summarized.At the same time,the factors affecting hospitalization cost were analyzed by single factor and multiple factor.Results:1.Overall,the total treatment cost of respiratory diseases in a central province was 5.85 billion RMB in 2019.The outpatient expenses were1.77 billion RMB(30.29%);The hospitalization cost was 4.08 billion RMB(69.71%).2.In terms of institutional distribution,the treatment cost of respiratory diseases in a province in Central China in 2019 mainly occurs in hospitals,which collectively is 4.36 billion RMB,accounting for 74.50% of the total treatment cost.Among the hospital costs,general hospitals accounted for the highest proportion,accounting for 82.37% of the hospital treatment costs,61.38% of the total treatment costs,and public health institutions accounted for the lowest proportion,9.18%.3.From the perspective of age and gender,the treatment costs were mainly concentrated in infants and young children(0-4 years old)as well as in the elderly population(≥ 60 years old),which in total spent 56.96% of their hygiene expenses.The population with the highest proportion of treatment costs in the full sample was infants and young children aged 0-4years,16.96%.Among the elderly group,the highest proportion was among those aged65-69 years,and the treatment cost of people over 70 years old is decreasing.The hygiene cost was 2.59 billion RMB for female patients and 3.26 billion RMB for male patients.4.Among the disease types,acute upper respiratory tract infection cost the highest 1.47 billion RMB and accounted for 25.23% of the total cost,followed by influenza and pneumonia,chronic lower respiratory tract infection,and its cost accounted for 21.48%,17.92%,respectively.5.Univariate analysis and multivariate analysis with non-parametric tests revealed that age,gender,days of hospitalization,surgery,type of insurance coverage,institution level,presence or absence of complications,and different municipalities all contributed to the cost of hospitalization.Conclusion: a province in Central China has a relatively high burden of cost for respiratory diseases,consuming a lot of health resources.Governments need to adapt their financing structures and reconfigure the costs of respiratory diseases to make the allocation of institutional flows and financing more rational.A province in Central China has a large scale of costs for the treatment of respiratory diseases,the costs are mainly concentrated in hospitals,and the costs of primary health institutions account for a relatively low percentage.The treatment cost was mainly concentrated in infants and young children as well as in the elderly population,in which the highest percentage of treatment cost was in the 0-4 years old group,the high cost of outpatient was concentrated in the lowest age group,and the high cost of hospitalization was concentrated in the high age group.In terms of the difference in costs by species,the largest proportion of costs was accounted for by acute upper respiratory tract infections.The costs of acute upper respiratory tract infections mainly occurred on an outpatient basis and the costs of chronic lower respiratory tract infections mainly occurred on an inpatient basis.The main factors affecting the hospitalization cost of patients are age,surgery,and complications.