Study on the relationship between the proportion of medical expenses and the rationality of the hospitalization expense structure in chronic heart failure
Objective To explore the relationship between the proportion of hospitalization expenses and the rationality of expense structure in patients with chronic heart failure(CHF),providing reference for early warning of unreasonable hospitalization expense structure and reasonable control of patients'hospitalization expenses.Methods Patients with CHF between 2020 and 2023 in Shanghai Pudong New Area Guangming Hospital of Traditional Chinese Medicine were used as the study data.Percentile algorithm was used to judge the rationality of the hospitalization expense structure.Multivariate logistic regression model was used to analyze the correlation between the proportion and rationality of expense structure.Restricted cubic spline model was to analyze the threshold response relationship.Results A total of 762 patients were included.The medicine expenses remained the primary component of hospitalization expenses for patients with CHF,and combined expenses of examination and laboratory tests exceeded 80％of the total hospitalization expenses.The incidence of unreasonable hospitalization expense structure in patients with CHF was about 10％.The proportion of traditional Chinese medicine,western medicine,examination and laboratory tests,age,admission mode and clinical pathway were the influencing factors of unreasonable hospitalization expense structure in patients with CHF.After coordinating the relevant variables,when the proportion of examination and laboratory tests was＜35％,the risk of unreasonable hospitalization expense structure decreased with the increase of the proportion[odds ratio=0.887,95％confidence interval(0.805,0.977),P＜0.01].While the proportion of western medicine expenses was＞30％,the proportion of traditional Chinese medicine expenses was＞13％,and the proportion of examination and laboratory tests was＞35％,the risk of unreasonable hospitalization expense structure increased with the increase of proportion(P＜0.01).Conclusions There is a correlation between the expense proportion of medicine,examination and laboratory tests and unreasonable hospitalization expense structure.The consumptive expenses should be reasonably controlled.
Hospitalization expense structurereasonable evaluation of expensesrestricted cubic splinechronic heart failure
万方数据
维普
