Objective To explore the relationship between the proportion of hospitalization expenses and the rationality of expense structure in patients with chronic heart failure (CHF), providing reference for early warning of unreasonable hospitalization expense structure and reasonable control of patient hospitalization expenses. Methods Patients with CHF between 2020 and 2023 in Shanghai Pudong New Area Guangming Hospital of Traditional Chinese Medicine were used as the study data. Percentile algorithm was used to judge the rationality of hospitalization cost structure, and multi-factor logistic regression model and restricted cubic spline model were used to analyze the correlation between the cost proportion and the rationality of cost structure and the threshold response relationship. Results A total of 762 patients were included. The cost of medicine remains the primary component of hospitalization expenses for patients with chronic heart failure, and the combined cost of examinations and tests exceeds 80% of the total expenditure. The incidence of unreasonable hospital cost structure in patients with CHF is about 10%. The proportion of traditional Chinese medicine (TCM), western medicine, examination and laboratory tests, age, admission mode and clinical route were the influencing factors of unreasonable hospital cost structure in patients with CHF. After coordinating the relevant variables, when the proportion of examination and laboratory tests was <35%, the risk of unreasonable hospitalization cost structure decreased with the increase of the proportion [odds ratio=0.887, 95% confidence interval (0.805, 0.977), P<0.01), while the proportion of western medicine expenses was >30%, the proportion of TCM expenses was >13%, and the proportion of examination and laboratory tests was >35%. The risk of unreasonable hospital expense structure increased with the increase of proportion (P<0.01). Conclusion There is a correlation between the proportion of the cost of drugs and examination and laboratory tests and the unreasonable structure of hospital expenses.
Objective To estimate healthy life expectancy of residents aged 30 and above in Jianyang, Sichuan province, and comprehensively evaluate the health status of the population, so as to provide reference and basis for the formulation of health-related public policies. Methods The population data, death data and health status data of Jianyang city in 2018 were collected, and the self-rated health life expectancy and life expectancy without chronic diseases of residents aged 30 and above were calculated by Sullivan method, and their proportion in life expectancy was calculated. Results A total of 4 482 residents aged 30 years and above were included in Jinyang city, of whom 3 989 were self-rated healthy, accounting for 89.00% of self-rated health, and 1 988 were suffering from chronic diseases, with a chronic disease prevalence rate of 44.36%. In the age group of 30-64, the self-rated health life expectancy of women was significantly higher than that of men (P<0.05), and in the age group of 40-44, the life expectancy without chronic diseases of women was significantly lower than that of men (P<0.05), and the differences were not statistically significant when comparing different genders in other age groups (P>0.05). With the increase of age, the proportion of residents’ self-rated health and the proportion of life expectancy without chronic diseases in healthy life expectancy gradually declined. Conclusions The chronic disease has become the main factor affecting the health of middle-aged and elderly population, especially female population. It is suggested that active measures should be taken to deal with chronic diseases and the elderly health support system should be strengthened to improve healthy life expectancy of residents in Jianyang city.