ObjectiveTo investigate old (the no less than 60-year-old) inpatient's diseases and cost constitution of a tertiary hospital in West China from 2008 to 2012, so as to provide baseline data for further research. MethodsThe case records of no less than 60-year-old inpatients in the tertiary hospital were collected from 2008 to 2012, and based on the first diagnose, the diseases were classified according to the International Classification of Diseases (ICD-10). The data including general information of the inpatients, discharge diagnosis, length of hospital stay and hospitalization costs, were analyzed using Stata10.0 software. Resultsa) The total number of old inpatients was 109 585, and male (59.57%) was more than female (40.43%). The disease spectrum included 18 categories. The percentage of old inpatients increased from 31.57% (2008) to 34.25% (2010). b) The top three systematic diseases were neoplasms, diseases of the circulatory system and diseases of the digestive; the male inpatients were more than the female; the number of inpatients who suffered from the top three systematic diseases got decreased with age increasing; neoplasm was the most common disease, there were 34 944 malignant neoplasm inpatients. c) The cumulative constituent ratio of the top five malignant neoplasms in male and female inpatients were respectively 62.51% and 49.44%; and the top five malignant neoplasms of male inpatients were malignant neoplasm of bronchus and lung, other medical care for neoplasm, malignant neoplasm of esophagus, malignant neoplasm of stomach and malignant neoplasm of prostate. The top five malignant neoplasms of female inpatients were other medical care for neoplasm, malignant neoplasm of bronchus and lung, malignant neoplasm of breast, malignant neoplasm of stomach and malignant neoplasm of cervix uteri. d) The average length of hospital stay decreased from 14.12 days to 11.00 days since 2008, and the average cost per capita increased from ￥14 044.79 yuan to ￥18 932.81 yuan since 2008. The proportion of drug cost of inpatients hospitalization cost decreased from 47.21% to 42.16% since 2008. ConclusionThe male inpatients are more than female in the tertiary hospital from 2008 to 2012. The most common systematic disease is neoplasm, especially the malignant neoplasms with higher constituent ratio. The top five malignant neoplasms of male inpatients and female are different. The average length of stay in hospitals has declined in five years, however the average cost per capita has increased.
ObjectiveTo analyze the main input and output of healthcare reform in China, and to provide references for improving the policies and measures of healthcare reform in China in future. MethodsData from the National Health Services Survey, and the China Statistical Yearbook etc. was collected to compare and analyze the allocation of health resources, health status of residents, health service utilization, and medical burden before and after healthcare reform. ResultsDuring the reform from 2009 to 2013, hospital health and technical personnel increased year by year. In 2013, the proportion of health and technical personnel in hospitals was up to 61.4% of the total national health technical personnel. In 2013, 65.19% of government expenditure on healthcare was used for disease treatment, and only 14.59% was used for disease prevention. Compared with the year of 2008, the two-week prevalence rate of residents increased by 5.2%, the chronic disease prevalence rate increased by 9% in 2013. Compared with the year of 2009, the annually diagnosed and treated patients increased 18.2 billion person-time, the annually discharged patients increased 59.65 million person-time in 2013. The individual residents paid 52.49% of total medical expenses. ConclusionSince the healthcare reform, China's central and local governments have imputed a large number of health resources into hospitals for "disease treatment". That partly improved the utilization of residents' health service, but the two-week prevalence rate and chronic disease prevalence rate are rapidly growing. There is still high burden of medical expenses for the residents. China's healthcare model should be changed from "treatment-centered" to "prevention-centered" in future.