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Analysis of the Outlier in the Case Payment of Laparoscopic Cholecystectomy

Objectives: Study wanted to explore the factors that will affect the total medical expense in the patients who receive laparoscopic cholecystectomy (LC). We also to confer the influencing factor that will associate with the difference of reports the expense under the case payment system.
Methods:Retrospective study . Collected from year 2003 to 2007, received LC in a general teaching hospital in Kaohsiung city. We also adopt the chart review and combined with the health insurance expense data to explore the important factors that were associated with total hospitalized expenses, declaration of expense differences, and profits. The methods of multiple linear and logistic regressions were needed.
Results: 1539 subjects, 613 male and 926 female. The average age was 54.4 , and 1313 subjects were hospitalized from outpatient. All subject¡¦s average hospitalized days were 3.79 and medical expenses were 42528.1 dollars. The frequencies of the type of declaration about ¡¥not exceed¡¦, ¡¥exceed but actually¡¦, and ¡¥exceed but no actually¡¦ were 88.8%, 8.6%, and 2.6%, in sequence. The average declaration of expense differences was 14484.1 dollars. The significant factors that were associated with total hospitalized expenses were the age, surgical year, source of hospitalize, major symptom, combine disease, a complication after surgery, hospitalized days, type of declaration. In the other linear regression model, we found the age, surgery year, source of hospitalize, major symptom, high technology examination before surgery, combine disease, a complication after surgery, hospitalized days, and physician¡¦s surgery quantity per year had been statistically significant with the declaration of expense differences. For the odds of hospital¡¦s profits, the significant factors include the surgery year, source of hospitalize, major symptom, high technology examination before surgery, and hospitalized days.
Conclusion: We found a few significant factors that were associated with dependent variable in three regression models in this study. The major factor is hospitalized days that were a stronger influence total hospitalized expenses, declaration of expense differences, and hospital¡¦s profits. The hospital¡¦s superintendent can carry on the management through the appropriate method to control the medical resource consumes.

Identiferoai:union.ndltd.org:NSYSU/oai:NSYSU:etd-0207111-154306
Date07 February 2011
CreatorsTung, Hong-Yi
ContributorsChen-Kuo Ker, Ying-Chun Li, Yuan-Yi Chia
PublisherNSYSU
Source SetsNSYSU Electronic Thesis and Dissertation Archive
LanguageCholon
Detected LanguageEnglish
Typetext
Formatapplication/pdf
Sourcehttp://etd.lib.nsysu.edu.tw/ETD-db/ETD-search/view_etd?URN=etd-0207111-154306
Rightsoff_campus_withheld, Copyright information available at source archive

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