How the resource allocation and inpatient behavior affect the expenditures of terminal malignant tumor patients?

Abstract Background: The inappropriate use of medical resources and escalating health expenditures of severe diseases patients has been a great concern in China’s health system especially among terminal stage. This study aims to analyze how the resource allocation and hospitalization behavior affect the expenditures of terminal malignant tumor patients, and provide evidences on resource allocation and utilization. Methods: An analysis framework of influencing factors of medical expenses was built according to Andersen’s Behavioral Model. Hospitalization expenditures of malignant tumor patients who died in medical institutions were tracked in Shanghai in 2016. We use path analysis to analyze the influencing factors of hospitalization expenditures at terminal stage. Results: Results demonstrated that hospital services and expenditures during the terminal stage were primarily in tertiary hospitals. The top three influencing factors were length of stay, number of admissions and level of medical institutions. While the influence of demographic characteristics (age, gender, type of medical insurance, etc.) was relatively low. Conclusions: Data suggest that hospitalization expenditures and patients’ economic burden can be reduced through adjusting allocation of medical resources and service utilization, as well as reducing unnecessary hospitalization days.