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| Structural equation model validation study on the influencing factors of high hospitalization expenses in dermatology hospitals |
| Lin Jinxiong1，Liu Jinlong2，Shen Shuqun1 |
1 Dermatology Hospital, Southern Medical University, Guangzhou 510091, China;
2 School of Health Services Management, Southern Medical University, Guangzhou 510515, China
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Abstract Objective To analyze the influencing factors of high hospitalization expenses in a certain tertiary dermatology hospital, and to provide references for reducing the medical burden of patients and optimizing the structure of medical cost.Methods The hospitalization data of patients with high hospitalization costs from 2015 to 2019 in a large tertiary dermatology hospital in Guangdong Province were taken as an example, and variance statistics and structural equation modeling were used to analyze the influencing factors of high hospitalization costs.Results Age (β=-0.072, P<0.001), surgery (β=0.157, P=0.001), hospital infection (β=0.043, P=0.030), readmission within the month (β=0.040, P=0.011), use of antibiotics (β=0.155, P<0.001), and the length of hospital stay (β=0.304, P<0.001) directly affected hospitalization costs, while age (β=0.028, P<0.001), marital status (β=0.021) , P＜0.001), comorbidity (β=0.026, P＜0.001), hospital infection (β=0.017, P＜0.001), use of antibiotics (β=0.089, P＜0.001), and clinical pathway (β=0.001, P=0.001) indirectly affected the hospitalization cost by acting on the length of stay, and the length of stay had the greatest impact on the high hospitalization cost of patients with skin diseases (β=0.304, P＜0.001).Conclusion Shortening the length of hospital stay, improving the level of surgery, rationally using antibiotics, controlling hospital infections, reducing comorbidities and readmission within the month, and improving clinical pathway management are one of the effective strategies to control the high hospitalization costs in dermatology hospitals. At the same time, the monitoring of elderly and married patients should be strengthened.
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Received: 29 March 2013
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