Abstract:

Objective To investigate the variation trend of hospital expenditure and its constitution in patients with acute myocardial infarction (AMI), and explore the influencing factors. Methods The information of home page of medical records of 1 880 patients with AMI hospitalized in Ruijin Hospital affiliated to Shanghai Jiaotong University School of Medicine between January 2007 and August 2012 was retrospectively analysed. The data of hospital expenditure were discounted by the consumer price indices based on 2012. Univariate analysis and multiple regression analysis were conducted to identify the main influencing factors of hospital expenditure. Results The hospital expenditure of patients with AMI exhibited a rising trend in general, and was mainly constituted by surgery fee (63.52%), medicine fee (17.57%) and examination fee (13.16%). The treatment charge and nursing charge ranked the lowest, which accounted for 0.34% and 0.38% respectively. The multiple regression analysis revealed that the times of admission, length of stay, ICU stay during hospitalization, surgery procedure and prognosis significantly affected the hospital expenditure (P<0.05). The partial regression coefficients indicated that length of stay had the greatest influence on hospital expenditure (b6=0.41), followed by surgery procedure (b8=0.35). The more times patients got into hospital, the less was the hospital expenditure (b4=－0.09). Patients who died in hospital cost more than the survival ones (b13=－0.08). Conclusion The control of hospital expenditure in patients with AMI is not favorable as a whole, which is embodied by the irrational constitution of hospital expenditure and underestimation of labor value of medical staff. The length of stay and surgery procedure were the main influencing factors of hospital expenditure. In the health care reform, more efforts should be made to regulate the behavior of doctors, shorten the average length of stay, so as to improve the efficiency of health resource utilization.

Key words: acute myocardial infarction, hospital expenditure, influencing factors