Objective To explore the structure and influencing factors of overall medical treatment expenses of 1 635 inpatients of Wenchuan earthquake in West China Hospital and to provide references for setting up the criteria of medical expenses and for assess the cost-effect of medical rescue and treatment. Methods The data of earthquake casualties were collected to analyze the constitution and influencing factors of the overall medical expense by SPSS 13.0 software. The data were described by X±SD. Comparison of data categories was tested by rank sum and influencing factors were analyzed by multi ple l inear regression analysis. Results A total of 1 635 casualties including 1 413 (86.04%) earthquake wounded and 222 (13.96%) patients from the disaster area were identified. The average expense per capita was 9 165.05±12 426.11 yuan. The overall cost was made up of operation expenses (71.75%) including material cost, examination fee and treatment fee, drug cost (18.41%) as well as bed fee and others (less than 10%). The cost of patients from the disaster area was higher than that of the earthquake wounded (Z= –4.109, P=0.000). The operation, compl ications, multiple-site damages, injures induced by the secondary disaster of the earthquake such as burn and corrosion were the direct reason leading to the high overall expense. The influencing factors included operation (r=0.386), ICU (r=0.336) and the day of hospital ization (r=0.246). Conclusion The earthquake wounded occupy the predominant percentage of the earthquake inpatients in West China Hospital. The operation, compl ications, multiple-site damages and injures induced by the secondary disaster of the earthquake lead to a high overall expense. The influencing factors include operation, ICU and the day of hospital ization. The relationship between the expense and the disease category largely depends on the classification criteria. The relationship between the expense and the age as well as the prognosis needs further study. But no correlation between the expense and the gender is found.
ObjectiveTo investigate the effects of single-disease quota payment in Chengdu.MethodsThe data of medical insurance in Chengdu from 2009 to 2013 were used to compare changes of average hospitalization expenses, hospitalization days, re-admission rate and so on by establishing a difference-in-difference (DID) model.ResultsThe quota payment policy effectively controlled the overall medical expenses. Drug fee and examination fee were significantly affected (P<0.01). However, the re-admission rate was significantly improved (P<0.10).ConclusionThe implementation of single-disease quota payment in Chengdu controlled the medical expanses growth effectively, but it is necessary to prevent its side effects.
Objectives To investigate the disease composition and medical costs of in patients with chronic kidney disease (CKD) in People's Hospital of Xinjiang Uygur Autonomous Region from 2012 to 2017. Methods To retrieve the records of patients with CKD, and to classify the main diagnosis of the first page of the medical record according to the International Classification of Diseases (ICD-10) standard. Data was analyzed using Excel 2010 and SPSS 19.0 software. Results A total of 11 650 CKD patients were included, with a sex ratio of 1.48 to 1. The patients were mainly young and middle-aged, accounting for 75.56%. The top 11 diseases of CKD patients were chronic glomerulonephritis, membranous nephropathy, diabetic nephropathy, IgA nephropathy, hypertensive nephropathy, minimally pathological nephritis, focal segmental glomerulosclerosis, lupus nephritis, Polycystic kidney disease, chronic interstitial nephritis and purpuric nephritis. The per capita hospitalization days of CKD patients was 11.23 days, and the per capita medical expenses was 1.51 million yuan. Significant differences were found in different genders, ethnic groups, age groups, disease composition and CKD staging. The medical expenses of CKD patients were mainly medicine and inspection fees, accounting for 71.35%. Conclusions Inpatients of CKD in the People's Hospital of Xinjiang Uygur Autonomous Region have a heavy disease burden and large difference in their conditions.
Objective To systematically review the impact of Beijing's comprehensive reform of medical consumption linkage on medical expenses, hospital services, and hospital income. Methods Databases including CNKI, WanFang Data, VIP, CBM, PubMed, and Web of Science were searched to collect empirical research on evaluating the impact of Beijing's comprehensive reform of medical consumption linkage on patient medical expenses and hospital operation (service volume and income structure) from June 15th, 2019 to August 15th, 2021. A descriptive analysis was performed after two reviewers independently screened the literature and extracted data. Results A total of 23 studies were included, and most of them found a relatively small change in the average outpatient and emergency medical expenses after the reform. However, the average inpatient expenses in some hospitals showed an increasing trend; the service volume of most hospitals increased slightly, and the income structure was optimized (e.g., surgery and other medical technology services revenue and its proportion increased). Conclusion The comprehensive reform of the medical consumption linkage in Beijing is the practice of deepening the reform of the medical service price mechanism. Based on the summary of the reform effect, it is recommended to further improve the price mechanism, improve service quality, and promote hierarchical diagnosis and treatment.