[Characteristics of patients and their medical cost on 14,398 hospitalized patients suffered form hepatitis B, from a hospital of infectious diseases located in Beijing].

OBJECTIVE: This article was to focus on the study of patient's profile, type and distribution of the disease and the related factors contributing to medical cost on 14 398 cases of hospitalized patients with hepatitis B from a hospital of infectious diseases located in Beijing, in order to provide basic information on optimizing the prevention and treatment strategies. METHODS: Information on hospital admission of patients with hepatitis B was collected and SPSS 16.0 statistics software package was used to analyze the profile, disease patterns distribution, structure of medical costs and main contributors related to medical costs. RESULTS: Through analysis, we found that the proportion of male patients was much bigger than that of female patients, with ratio as 2.9. The average age of patients with hepatitis B was 45.2 years old. The treatment process was time consuming, and the mortality rate was high. Our data showed that the mortality of hospitalized patients was up to 7% and the average age of death was 55 years old. Hepatitis B infection was easy to develop into chronic, cirrhosis and even liver cancer. For treatment cost, the largest cost share was the drugs being used which accounted for 62.4%. In terms of health care costs, it was high and the total cost of hospitalization was related to the following factors:days of hospitalization;complexity of the disease condition and the factors as the severity of the disease complications as surgery, frequencies of rescue, type of disease etc; basic information of the patients as age, occupation, origin. CONCLUSION: Compared with other diseases, the proportion of male patients with hepatitis B was much higher than that of the female. Hepatitis B had a longer duration and difficult, treatment high cost of medical care, poor prognosis, high mortality rate; Cost control, can not simply fixed by single disease, but by complexity of the disease and patient characteristics.

[Using diagnosis relative groups mortality risk classification to assess medical quality].

OBJECTIVE: To introduce diagnosis related groups to assess the medical quality and try to establish an effective quality evaluation approach. METHODS: Using Australia-Refined Diagnosis Related Groups, version 5.0 (AR-DRGs v5.0) to classify the 160 000 discharged cases from 7 large hospitals in Beijing in 2005. Based on this, mortality risk classification was established to adjust the whole-hospital risks. And then hospital mortality of all the risk groups from each hospital was calculated respectively, which was used as the basic quality assessment criterion. The differences between the assessment results from using the raw hospital mortality and from using Diagnosis Relative Groups Mortality Risk Classification (DRGs-MRC) were compared. RESULTS: (1) The risk types were different among the discharged cases in different hospitals; (2) The assessment results from these two approaches about No.6 hospital were similar in that No.6 hospital had a good quality performance; (3) The raw hospital mortality was the lowest in No.2 hospital (0.98%), but the mortality of low risk group in this hospital was higher than the average level of the same risk group among these 7 hospitals; the status of No.5 hospital was much the same. CONCLUSION: Compared with raw hospital mortality, DRGs-MRC improved the comparability of cases and the reliability of the assessment result.