Time series prediction analysis of average hospitalization expenditure and drug proportion of diabetes patients in a grade-a tertiary hospital in Zhejiang province / 现代医院

Objective This study conducted the ARIMA model to analyze the cost structure and trend of inpatients with diabetes in a grade-A tertiary hospital and provide scientific basis for effectively controlling diabetes hospitalization expenses and reduce patient's economic burden.Methods The data of 18 371 inpatients with diabetes from 2012 to 2022 in a grade-A tertiary hospital were collected.We collected inpatient data of diabetes from 2012 to 2021 to fit the average inpatient expenses and drug proportion,and used data 2022 to verify the effect of model prediction.We predicted the average inpatient expenses and drug proportion from 2023 to 2025.Results The difference between the predicted value and the actual value was small,and the mean absolute percentage error was within the acceptable range.ARIAM model could be used to predict the expenses of diabetes.Conclusion The average cost of hospitalization showed a decreasing trend,and"the five colors,one map,one index"manage-ment model has achieved results.The proportion of drugs decreased obviously,but the composition of hospitalization expenses should be further optimized.The research of expenses prediction based on diabetes needs to be depended.

Comparison of healthcare expenditures and self-payment among patients with lung cancer in Wenling City before and after implementation of diagnosis-related groups (DRGs) / 预防医学

Objective@#To investigate the healthcare expenditures and self-payment among patients with lung cancer in Wenling City before and after implementation of diagnosis-related groups (DRGs), so as to provide the evidence for controlling medical costs and relieving burdens of patients with lung cancer. @*Methods@#The basic data and healthcare expenditures of lung cancer patients that were definitively diagnosed from 2015 to 2019 and covered by medical insurance were captured from the cancer registration database of Wenling Center for Disease Control and Prevention and the database of chronic and specific diseases in Wenling Bureau of Medical Insurance. The changes of outpatient expenditures, inpatient expenditures and self-payments were compared before (2015-2016) and after implementation of DRGs (2018-2019) among lung cancer patients.@*Results@#Totally 4 947 lung cancer patients covered by medical insurance were enrolled in this study, including 3 052 males (61.69%) and 1 895 females (38.31%), with a mean age of (64.88±11.64) years. The annual mean healthcare expenditure was 56 675.85 Yuan per capita during the period between 2015 and 2016, in which 14.48% were outpatient expenditures and 85.52% were inpatient expenditures, and the annual mean healthcare expenditure was 38 702.94 Yuan per capita during the period between 2018 and 2019 (a 31.71% reduction as compared to that in 2015 and 2016), in which 24.49% were outpatient expenditures and 75.51% were inpatient expenditures. The proportions of outpatient expenditures, inpatient expenditures and total self-payments consisted of 25.38%, 32.49% and 29.67% of total healthcare expenditures in 2018 and 2019, which were significantly lower than those (50.84%, 50.96% and 50.95%, respectively) in 2015 and 2016 (χ2=13.741, P<0.001; χ2=7.015, P=0.008; χ2=9.340, P=0.002).@*Conclusions@#The annual mean healthcare expenditures per capita and the proportion of self-payment reduce among lung cancer patients covered by medical insurance following implementation of DRGs.

Health care inequities in north India: Role of public sector in universalizing health care.

Background & objectives: Income inequality is associated with poor health. Inequities exist in service utilization and financing for health care. Health care costs push high number of households into poverty in India. We undertook this study to ascertain inequities in health status, service utilization and out-of-pocket (OOP) health expenditures in two States in north India namely, Haryana and Punjab, and Union Territory of Chandigarh. Methods: Data from National Sample Survey 60th Round on Morbidity and Health Care were analyzed by mean consumption expenditure quintiles. Indicators were devised to document inequities in the dimensions of horizontal and vertical inequity; and redistribution of public subsidy. Concentration index (CI), and equity ratio in conjunction with concentration curve were computed to measure inequity. Results: Reporting of morbidity and hospitalization rate had a pro-rich distribution in all three States indicating poor utilization of health services by low income households. Nearly 57 and 60 per cent households from poorest income quintile in Haryana and Punjab, respectively faced catastrophic OOP hospitalization expenditure at 10 per cent threshold. Lower prevalence of catastrophic expenditure was recorded in higher income groups. Public sector also incurred high costs for hospitalization in selected three States. Medicines constituted 19 to 47 per cent of hospitalization expenditure and 59 to 86 per cent OPD expenditure borne OOP by households in public sector. Public sector hospitalizations had a pro-poor distribution in Haryana, Punjab and Chandigarh. Interpretation & conclusions: Our analysis indicates that public sector health service utilization needs to be improved. OOP health care expenditures at public sector institutions should to be curtailed to improve utilization of poorer segments of population. Greater availability of medicines in public sector and regulation of their prices provide a unique opportunity to reduce public sector OOP expenditure.

Analysis of the hospitalization expenditure of cervical cancer patients and influencing factors / 中华医院管理杂志

Objective To analyze the variations and influencing factors of hospitalization expenditure of cervical cancer patients among urban employees in Beijing from 2006 to 2010,and to provide evidences for developing reasonable measures of medical expenses control.Methods Based on the hospitalization expenditure data of 1146 cervical cancer cases,the paper probed into the changes of hospitalization age and hospitalization expenditure,and the influencing factors of hospitalization expenditure by means of descriptive analysis and multiple stepwise regression.Results The last 5 years witnessed no significant change in the first hospitalization age of cervical cancer patients,rise of hospitalization age,gradual rise of the hospitalization expenditure per time along with their age groups,as well as a rising trend of the average hospitalization expenses,average drug cost and proportion of average drug cost year by year.Results of the multiple stepwise linear regression showed that days of stay,proportion of drug cost and surgery or not as important influencing factors for hospitalization expenditure.Conclusion Hospitalization expenditure of cervical cancer keeps growing.Against this background,reasonable shortening of the days of stay,reasonable setup of an appropriate proportion of out-of-pocket payment,and reduction of the proportion of drug costs become effective means to reduce hospitalization expenditure.

Composition and Influential Factors of Hospitalization Expenses in Inguinal Hernia Inpatients Under the Single-disease Payment Standard of Medical Insurance / 药物流行病学杂志

Objective:To analyze the hospitalization expenses in inguinal hernia inpatients under the single-disease payment standard of medical insurance.Method:A retrospective study was performed to analyze the data of inguinal hernia patients who received inguinal herniorrhaphy in 2006.According to the regulations worked out by the Beijing Medical Insurance Affairs Administration,32 cases were selected and their medical costs were characterized.Result:The average hospitalization expense in inguinal hernia patients was 5722.37?2967.66 yuan,including surgery cost(45.6%) and drug cost(26.7%).The surgery cost level depended on the selection of various hernia prosthetic mesh and the drug cost depended on the selection of various anti-infective drugs.The hospitaliztion expenditures were lower in 18 cases than the payment permission in the medical insurance standard but higher in the other 14 cases.The sex composition,surgery cost, drug cost and laboratory cost showed a significant difference between the two groups(P

Laparoscopic cholecystectomy versus open cholecystectomy: Clinical efficiency and costs analysis / 中国微创外科杂志

Objective To compare the costs and effectiveness between the laparoscopic cholecystectomy (LC) and the open cholecystectomy (OC). Methods Clinical data of 97 patients treated either by LC (n=41) or OC (n=56) were retrospectively reviewed. Results The hospital stay, postoperative hospital stay, hospitalization expenditure and medical incomes in Group LC and Group OC were (11.4?3.0) days and (15.1?4.2) days (t=-4.811,P=0.000), (6.1?0.9) days and (10.7?2.4) days (t=-11.673,P=0.000), (8 723.8?1 077.2) yuan and (6 423.4?1 398.4) yuan (t=8.791, P=0.000), (6 236.4?591.0) yuan and (3 426.6?683.2) yuan (t=21.162,P=0.000), respectively. There were no statistical significances between the two groups in preoperative hospital stays and occurrences of complications (t=1.684, P=0.095;?2=0.434,P=0.510). Conclusions Compared with the OC, health resources were more properly utilized but costs were higher in the LC.