Changing trends of hospitalization expenses and their influencing factors among diabetic patients in a Grade-A tertiary hospital in Shaanxi Province, 2017-2021
CHEN Yu, FENG Ting, ZHANG Huihui, JIA Aihua
The First Hospital of Yulin, Yulin, Shaanxi 719000, China
Abstract:Objective To analyze the composition and changing trends of average hospitalization expensesand their influencing factorsin diabetic patientsin the past five years, and to provide a reference basis for effectively reducing the economic burden of diabetic patients. Methods Diabetic patients hospitalized in the First Hospital of Yulin from 2017 to 2021 served as the researchsubjects, and their general information and hospitalization cost information were obtained from the case information system. SPSS 25.0 software was used to perform the nonparametric rank sum test, and a multiple linear regression model was established to analyze the average hospitalization expenses of diabetic patients and their influencing factors. Results A total of 7,922 diabetic patients were enrolled into this study, with an average age of (53.86±13.13) years and the average hospitalization expenses of (7,935 (6,442, 9,733)) Yuan. From 2017 to 2021, the average hospitalization costs decreased from 8,569 Yuan to 7,641 Yuan, the percentage of drug expenditure dropped from 43.21% to 38.28%, and the average hospitalization expenses were mainly composed of drug expenses (39.21%) and laboratory test expenses (38.87%). The results of multiple linear regression analysis displayed that age (b=0.001), length of hospital stay (b=0.026), mode of admission (outpatient service as a reference, emergency department b=0.053), complications (b=0.060), operation (b=0.073), referral (b=0.065), and use of traditional Chinese medicine (b=0.042) were positively correlated with the diabetes patients’ average hospitalization costs. Marital status (the unmarried as a reference, the married b=-0.037) and the year of hospitalization (2017 as a reference, 2018 b=-0.018, 2019 b=-0.018, 2020 b=-0.015, 2021 b=-0.015) were negatively related to the diabetes patients’ average hospitalization costs. Conclusion The composition of the diabetes patients’ average hospitalization expenses needs to be optimized. Age, length of hospital stay, emergency admission, complications, operation, referral and use of traditional Chinese medicine are the factors influencing the hospitalization expenses, among which length of hospital stay, referral and use of traditional Chinese medicine are the influential factors that medical institutions can control. It is suggested that we should standardize the clinical path, promote the construction of local hierarchical diagnosis and treatment system and build a multidisciplinary diagnosis and treatment model so as to effectively alleviate the diabetes patients’ economic burden.