Study on the Composition and Influencing Factors of Hospitalization Expenses for Rural Residents with Trauma
Objectives This study aims to explore and analyze the internal composition and influencing factors of hospitalization expenses of trauma patients in rural areas,so as to provide a theoretical basis for making management decisions to reduce the economic burden of disease in rural residents with trauma.Methods 9,493 pieces of medical record front page information of rural trauma patients in a top-three hospital in Yunnan Province from January 1,2018 to December 31,2021were extracted.Grey correlation analysis,single factor analysis,multiple linear regression analysis,and random forest regression tree model were used to study the composition and influencing factors of hospitalization costs of rural trauma patients.Results From January 1,2018 to December 31,2021,the hospital's hospital expenses for trauma patients in rural residents showed a decreasing trend,with an average annual growth rate of-2.82％.The results of the correlation analysis of internal factors of hospitalization expenses showed that the consumables cost and drug cost had the highest correlation with hospitalization expenses,and the correlation degrees were 1.00 and 0.84,respectively.Single-factor analysis screened out 8 external factors such as age,length of hospitalization,route of admission,and location of injury that have a significant impact on hospitalization costs(P＜0.001).The results of multiple linear regression model analysis showed that 10 factors,except gender,comprehensive medical service fee,diagnosis fee,treatment fee,blood and blood products fee,and other costs,significantly affected the hospitalization cost.Furthermore,the random forest regression tree model was used to rank the importance of these internal and external factors.The results showed that the proportion of consumables,the length of hospital stay,whether the third or fourth-grade surgery,the proportion of drugs,and whether the ventilators were used ranked among the top five influencing factors.Conclusions The health and prevention education of trauma diseases in rural residents should be strengthened.It is necessary to increase the proportion of service expenses reasonably to ensure the comprehensive upgrading of consumable and drug reform on the basis of improving the quality of medical services,so as to optimize the internal structure of hospitalization expenses for rural residents.The hierarchical diagnosis and treatment system should be promoted,and the clinical pathway should be standardized to reasonably shorten the length of hospital stay and effectively reduce the economic burden of disease.
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