Control Study About Inpatient Expenditure Between Army And Social Insured Retiree With Cardiac-Cerebral Vascular Diseases

As a multilayer magnificent system, health care policy should be evaluated from every view for the propriety and rationality. To finding the problem, the multi-disciplines and multilevel evaluation was accompanied all the time with the establishment and reform of medical insurance system in the western countries. The economic evaluation is taken more and more when our govement implementing the new health care policy/or cost-containment policy. The multi-disciplines and multilevel evaluation for the rationality of the health care expenditure should be launched when the army health care spending accelerated rapidly and an economic-containment seems imminent. The objective of this study is to analyze health care expenditure and to isolate the independent effects of health insurance status on influencing expenditures for army retiree inpatient, after controlling for confounding factors such as health status, medical conditions, and other socioeconomic factors. Data From: Xijing Hospital and Lanzhou Military General Hospital. According to including criteria and matching categories of the study, 1107 inpatients' case notes and their balance bills who diagnosed as coronary heart disease, hypertension and cerebral-infarction from 2001-2003 were collected. A Grouped Comparison Trail was used in the study, with army retireeinpatient as study group and social insured retiree inpatient as control group. Using Spss 11.5 package, the social characters and health status for both group are statistically described and equipoised. The total hosital expenditure is the dependent variale used in the analysis. The mean and median of data for hospitalization expenditure and treatment quality are computed, nonparametric or parametric tested were used for the analysis according to the distribution status of the data. The median of the expenditure and the nonparametric test were used for hospitalization expenditure analysis because its distribution tents to be skewed rather than normally distrbution. Finally, In order to evaluate the relative effects of a variety of insurance-level characteristics on inpatient expenditures per member stepwise multivariate regression was employed in an exploratory data analysis. Significance level for all test is <0.05.For Coronary Heart Diseases: (1)The mean hospital expenses for the most inpatient was below Y 10,000. Therapeutic expenditure was the largest proportion of the cost for both group, the second and the third proportion were medication and apparatus or chymistry test. (2)Total expenditure and expenditure for medication, therapy of army group was significant lower than social group, but bed fee was significant higher. (3)Interventional cardiology, treatment result and intensive care were the most important influencing factors for the inpatient cost, in addition, the length of stay and nosocomial infection also accelerated the hospital expenses for army group, but not for social group, that may indicate better cost-effect for social group, (4)interventional cardiology is negative with hospitalization length. (5)Hospitalization length of the army group is significant longer than social group. (6)Nosocomial infectionrate of army group is significant higher.After all: expenditure for interventional cardiology is the major component of the hospital expenses, but interventional cardiology improved the cure rate, shorten the length of hospitalization, reduced the rehospitalization, and its incremental analysis also indicated better cost-effectiveness; Army inpatient taken invasive therapy less than social group. The study suggests that taking more effective therapeutic technique to reduce the hospitalization length and nosocomial infection rate will be useful in improving the cost-effectiveness for army inpatient.For Hypertension: (1)for the most inpatient, the inpatient expenditure was beloweYi0,000. (2)Apparatus or chymistry test is the major portion for army group, medication is the major portion for social group. (3)The proportion of bed fee for army group is 16.05%, for social group is 5...