The Study Of Economic Burden Of Stroke Patients And Its Influencing Factors In Henan Province

ObjectiveTo understand the direct and indirect medical costs of stroke patients in Henan province,to analyze the factors affecting the economic burden of stroke patients.Putting forward the effective methods to reduce the economic burden of patients with stroke and the measures to prevent the disease,so that the Henan provincial health administrative departments to make health decisions can be followed.MethodsUse of Henan Province health services survey data in 2013,choose from 497 patients with stroke,and the index related with the subject,such as the basic situation of patients,family economic situation and the accessibility of health services,two weeks of injury,patients hospitalization etc.Based on these data,the two step model and human capital method were used to measure the direct economic burden and indirect economic burden of patients.Using the single factor rank test,to test the economic burden of stroke factors of differences between the groups,the test level was 0.05,using multiple linear regression to analyze the factors of direct economic burden(outpatient and inpatient)and the indirect economic burden,the test level was 0.05.Results(1)Total of 497 stroke patients in the survey,63.4% of the patients over the age of 60,34.6% of the patients with the education of primary school,44.5% were unemployed;the city accounted for 47.9% of patients,patients in rural areas accounted for 52.1%;the per capita income of urban and rural stroke patients was 20000 yuan,per capita annual expenditure was 18050 yuan,of which the medicine and the medical service expenditure accounted for 28%.(2)There were 77.7% of stroke patients from home to the nearest medical institutions less than 1 km,only about 2.8% from the nearest medical institutions in more than 3 km;the medical insurance rate was 100%;there were 70.65% patients with stroke first choice for treatment was medical institutions,25% of the patients selected county hospital,4.35% of the patients selected city hospital;about 44.31% of stroke patients were admitted to the county hospital,34.40% stroke patients hospitalized in the primary care unit,and 20.12% patients hospitalized in the city hospital.(3)The total economic burden of stroke patients in Henan province was11 billion 872 million yuan,of which the direct economic burden was 10 billion 609 million yuan,accounting for about 89.36% of the total cost,and the indirect economic burden was 1 billion 263 million yuan,accounting for 10.64% of the total cost.(4)The type of income and medical institution had impacts on the outpatient service fee(P<0.05),the higher of the medical institutions level,the higher costs of patients,and the higher income of patients,medical expenses would be higher.(5)The type of inpatient institution,whether the operation and the length of hospital stay were the influencing factors of hospitalization expenses(P<0.05),with the increase of the type and the length of hospital stay,the cost of medical treatment increased,the standard of hospitalization expenses also increased,result in the direct costs of patients increased;the direct economic burden of patients undergoing surgery was higher than that of patients who did not undergo surgery.(6)Gender and type of institution have an impact on the patient's indirect economic burden(P<0.05).In other cases,the indirect economic burden of men is higher than that of women,which may be related to the habit of seeking medical treatment.With the increase inpatient institutions,the length of hospitalization and treatment time of patients,and the indirect economic burden would be increased.ConclusionIn 2013,the economic burden of stroke patients in Henan province is heavy,and the proportion of drug and medical expenditure accounted for a large proportion of patients.The health service accessibility of stroke patients in Henan province is better,and the first choice of medical institutions are primary health care institutions and county hospitals. the main factors that affect the economic burden of stroke patients are the type of institutions and length of hospital stay.