Abstract：Objective To provide basis by analyzing the medical expenses and influencing factors of inpatients with different types of medical insurance in order to effectively reduce the economic burden of chronic disease patients.Methods The medical expenses data，basic medical insurance reimbursement data and the basic information of the first page of medical records of hospitalized patients with diabetes，cancer，stroke and chronic obstructive pulmonary disease（COPD）admitted in a hospital from 2015 to 2016 were collected and divided into urban workers，urban residents and the new rural cooperative medical care by type of medical insurance，and compared the direct medical expenses burden and influencing factors in different medicare type patients.Results A total of 20 949 patients were enrolled，including 10 558 males and 10 391 females，with an average of 57.08 ± 13.85 years old. The patients numbers of urban workers，urban residents and new rural cooperative medical care accounted for 43.5%，11.0% and 45.5% respectively. The direct medical costs，non-compensable expenses and their proportion，self - paid expenses and their proportions in patients with different types of chronic health care were significantly different （P<0.05）. Among the various expenses，the expenses of medicines in all types of insured patients were the highest. Among the three kinds of chronic diseases such as diabetes，cancer and chronic obstructive pulmonary disease，the direct medical costs of the new rural cooperative medical care were the lowest，non-compensable expenses and their proportion，self - paid expenses and their proportion of the new rural cooperative medical care were the highest. Among the stroke patients，the direct medical expenses of urban workers were the lowest，but non-compensable expenses and their proportion，self-pay costs and their proportion of the new rural cooperative medical care are also the highest. The factors such as age，sex，hospital stays，type of insured and other factors were related to direct medical costs （P>0.05）.Conclusion There were significant differences in the direct medical costs among patients with different medical insurance types of diabetes，cancer and COPD. Age and hospital stays were the main influencing factors of the direct medical cost burden on four kinds inpatients with chronic diseases.
王志华，张析哲，曲建卫，咸本松. 不同医保类型慢性病住院患者直接医疗费用负担及影响因素分析[J]. 预防医学, 2018, 30(8): 780-784.
WANG Zhi-hua，ZHANG Xi-zhe，QU Jian-we，XIAN Ben-song. Direct medical expenses of hospitalized patients with chronic diseases and its influencing factors. Preventive Medicine, 2018, 30(8): 780-784.
