The Study Of The Insured And Uninsured Inpatient Expenses And The Influence Factors

Built in 1 950s, Chinese medical support system need to be reformed, while medical expenditure is soaring with the swift progress of national economical construction, the amelioration of health care and increase of medical requirement. In 1995, the experimental works were lunched to reform the health care system in China. China has been establishing an insurance system with the combination of social financing medical fimd and individual medical account for urban employees since 1998. The over increase has been controlled at a certain extent by the medical restrict mechanism. The evaluation study for medical insurance program is related with medical insurance financing, management, use, control and the quality, cost and benefit, market of medical service. To find the problem in the practicing, the multi-disciplines and multi-level evaluations were accompanied with the 6 5 establishment and reform of medical insurance system in western countries. The evaluation is more important for new launched Chinese medicare. To analyses the medicare expenses, three largest hospitals which are charged the medical insurance duties are chosen. The collected data include: the first pages of the 23503 inpatients?medical records and their balance bills, and the balance bills of 656 medicare inpatients of 2 hospitals from October,2000 to March,200 1; the balance bills of 117 medicare inpatients of the third hospitals from October, 2000 to March. 2001. The data of first pages of medical record and inpatient cost are pre-processed by eliminating the records with uncompleted terms and illogical cases so that 22583 valid cases are gotten. Furthermore, to ensure the comparability for insured and uninsured, we eliminate: military beneficiaries, inpatients who are younger than 16, inpatients who are for health examination, inpatients who are in hospital longer than 3 months and inpatients who spend less than 100. Using SAS 8.1 package, the social characters for both insured and uninsured inpatients are statistically described. The expense distributions of hospitalization for both insured and uninsured inpatients are analyzed. The mean and median of different hospitalization fees are computed and nonparametric tested for the component analysis. Finally, multi-regression method are applied to analyses the factors that influence the cost. By analyzing the cost for insured and uninsured inpatients, it has been found that there are significant differences for the various ages groups, genders, hospitals and departments. The cost increases with the age and male抯 cost is higher than female. While the cost in department of Dermatology is lowest, the cost in comprehensive department and surgical departments is highest. The cost 7 of the insured is lower than the uninsured and the cost on drugs of the insured falls though the largest part of the cost is medication for both insured and uninsured. The length of stay is the most important influence factor for the cost. The above results show the hospitalization cost of insured is decreasing because of medication control and the length of stay is the most important influence factor for the cost, after the urban employees medicare system launched. To know the burden of the insured hospitalizati...