Economic Burden Of Hepatitis B Inpatients With Urban Employee Basic Medical Insurance In Tianjin

Objectives: This study is designed to explore the economic burden of hepatitis Binpatients with Urban Employee Basic Medical Insurance in Tianjin. The objectiveshave three aspects, which include the expenses of hospitalization and the componentsconstituting as well as the factors affecting them. This research aims at providingreference data for the health insurance sector decision-making and thepharmacoeconomic evaluation.Methods:30%sample of the Tianjin Urban Employee Basic Medical Insurancedatabase from2003to2007was used to conduct this study. Hepatitis B patients weredivided into acute hepatitis B patients, chronic hepatitis B patients, hepatitis Bcomplicated with cirrhosis patients and hepatitis B complicated with hepatic cancerpatients by their disease state. Descriptive statistical analysis was conducted to studythe expenses of hospitalization and its components. Multiple linear regression wasconducted to identify the factors affecting the cost of inpatients.Results:①The average cost of hospitalization per visit for acute hepatitis Bpatients, chronic hepatitis B patients, hepatitis B complicated with cirrhosis patientsand hepatitis B complicated with hepatic cancer patients were13733.3RMB,14521.7RMB,16463.2RMB and23986.5RMB respectively. The individual burdenaccounted for24.8%,25.8%,25.9%and31.7%respectively.②The average annualcost of hospitalization per person for chronic hepatitis B patients, hepatitis Bcomplicated with cirrhosis patients and hepatitis B complicated with hepatic cancerpatients were25007.6RMB,37850.3RMB and53773.6RMB respectively. Theindividual burden accounted for28.2%,25.3%and29.3%respectively.③Theaverage drug fee exceeded9000RMB per visit and13000RMB per year for eachperson, which made up the largest proportion (over55percent) of the hospitalizationcost.④The average examination fee ranged from1662.8RMB to3315.9RMB pervisit and from3385.7RMB to7032.1RMB per year for each person, occupying thesecond largest percentage (over11percent) of the hospitalization cost.⑤Despite thecost of hospitalization per visit in tertiary hospital was4605.9RMB to8251.0RMBhigher than that in secondary hospital, a majority of patients still chose tertiaryhospital for treatment.⑥Multiple linear regression demonstrated that the influencing factors of the expenses of hospitalization per visit included the category of diseasestate, age, gender, length of stay and the class of hospital. The influencing factors ofthe annual expenses of hospitalization included the category of disease state, theannual hospitalization days in tertiary hospital, the annual hospitalization days insecondary hospital and times of hospitalization in tertiary hospital per year, while ageand gender were not included.Conclusions: There is high hospitalization expense for hepatitis B inpatients withUrban Employee Basic Medical Insurance in Tianjin. With the increasing severity ofthe disease, the cost tends to rise constantly, posing considerable economic burden tothe patients, their families as well as the society. The spending on drug andexamination take up the largest proportion among other components. To ease thehepatitis B inpatients’ economic burden, decision-makers are recommended to inflicteffective policy to reduce the cost of drug, avoid unnecessary examinations and guidepatients to select the most suitable hospitals for treatment rationally.