Analysis of the cost composition and influencing factors of Chinese medicine advantageous diseases

With rising medical costs and increasing health insurance payment pressures in China, optimizing resource allocation and enhancing diagnosis efficiency for TCM (traditional Chinese medicine)-privileged diseases (e.g., stroke, facial paralysis, bone bi-syndrome) has become critical. These diseases, valued for their standardized protocols and curative advantages, are prioritized in national policies. This study analyzes their cost composition and core drivers to inform medical cost control and policy optimization. Using 2023 outpatient/inpatient data from pilot hospitals in Hubei (782 stroke, 294 facial paralysis, 244 bone bi-syndrome cases), Gray relational analysis and multiple linear regression quantified cost structures and influencing factors. Data were logically reviewed, excluding cases with abnormal hospitalization days (<1 or >180 days) or unreasonable costs, focusing on TCM treatment fees, diagnostic costs, and length of stay (LOS). TCM treatment fees dominated costs (41% for stroke, 48.05% for facial paralysis, 33.4% for bone bi-syndrome), driven by diverse therapies like acupuncture and herbal medicine. Diagnostic fees followed (16.2%, 15.25%, 22.14%), linked to imaging/laboratory tests. LOS was the strongest driver of total hospitalization costs (standardized coefficients: 0.746 for stroke, 0.697 for facial paralysis, 0.548 for bone bi-syndrome). Age and gender showed partial significance in univariate analysis but not in multivariate models. Cost structures are TCM-treatment-oriented, with LOS as the key cost driver. Recommendations include optimizing health insurance payment weights via diagnosis-related group-differentiated compensation, refining hospitalization management to reduce unnecessary LOS, and building multidimensional cost-effectiveness research networks integrating machine learning and cost-effectiveness analysis to balance costs and efficacy for sustainable TCM development.