|
|
|
| Direct medical expenses of hospitalized patients with chronic diseases and its influencing factors |
| WANG Zhi-hua*，ZHANG Xi-zhe，QU Jian-we，XIAN Ben-song
|
| *Chifeng Clinical Medical College of Inner Mongolia medical university，Chifeng，Inner Mongolia 024000，China |
|
|
|
|
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.
|
|
Published: 25 July 2018
|
|
|
|
|
|
[1] 秦江海. 中国慢性病及相关危险因素流行趋势、面临问题及对策[J] . 中国公共卫生，2014，30（1）：1-4.
[2] 张益丹，谢开婿，潘东霞，等. 桐乡市主要慢性病流行特征分析[J] . 预防医学，2017，29（7）：727-730.
[3] 胡建平，饶克勤，钱军程，等. 中国慢性非传染性疾病经济负担研究[J] . 中国慢性病预防与控制，2007，15（3）：189-193.
[4] 曲建卫，王志华，咸本松. 内蒙古某三级甲等医院各医保类别住院患者直接医疗经济负担分析[J] . 中国医院，2017，21（8）：56-58.
[5] 陶建华，马岩，朱兵，等. 绍兴市主要慢性病发病特征[J] . 浙江预防医学，2014，26（12）：1236-1237.
[6] 金捷红，周杨青. 东阳市四种慢性病报告发病率分析[J] . 预防医学，2017，29（1）：76-78.
[7] 刘扬河，刘跃伟，周鹏，等. 海口市某医院老年慢性病患者医疗费用调查[J] . 医学与社会，2015，28（9）：13-15.
[8] 白书忠，武留信，陈刚. 中国慢性非传染性疾病管理的目标与对策[J] . 中华健康管理学杂志，2009，3（6）：323-328.
[9] 王东进. 全民医保在健康中国战略中的制度性功能和基础性作用（下） [J] . 中国医疗保险，2016（12）：9-11.
[10] 李静，马效恩，华永新，等. 基于结构变动度的不同付费方式住院医疗费用控制研究[J] . 中国医院管理，2015，35（12）：65-67.
[11] 刘慧，肖新才，张丹萍，等. 2008—2014年广州地区8所大型综合性医院老年人群急性呼吸道感染住院状况与直接经济负担分析[J] . 现代预防医学，2017，44（4）：650-653，664.
[12] 钱思兰，梅洵. 糖尿病患者治疗依从性与病情控制和医疗费用调查分析[J] . 中国实用护理杂志，2013，29（5）：60-62.
[13] 司明舒，李士雪. 菏泽市公立医院五种慢性病医疗费用的支付方式调查[J] . 中国卫生经济，2017，36（2）：58-60.
[14] 路平，周守君，季花，等. 肿瘤专科医院出院病人医药费用构成及其变化分析[J] . 江苏卫生事业管理，2016，27（3）：92-94.
[15] 艾尼瓦尔·艾木都拉，巴合提牙尔·祖农，包永星，等. 综合性医院肿瘤患者医保费用超额情况影响因素分析[J] . 现代医院，2017，17（4）：476-479.
[16] 李亢，余正. 某院2010年脑卒中患者住院医疗费用及其影响因素分析[J] . 中国执业药师，2011，8（7）：23-26.
[17] 钱治军，赵艳芳，何倩，等. 上海市6所三甲医院脑卒中住院患者费用分析[J] . 解放军医院管理杂志，2014，21（10）：978- 980.
[18] 王连红，罗倩，张莉. 遵义地区2014年慢性阻塞性肺疾病患者疾病费用分析[J] . 贵州医药，2015，39（11）：1048-1049.
[19] 罗万桥，邓强，李文胜. 多层次医疗保险体系对糖尿病患者保障状况及其费用补偿机制研究[J] . 中国医疗管理科学，2015，5（4）：34-37. |
|
|
|
