The Analysis Of The Insured And Uninsured Inpatient With Chronic Disease Expenses And The Influence Factors

Objective : This topic through investigates in hospital expense situation of 5 kinds of chronic disease which in two three level of first-class general hospital, compare with expense and the constitution of the insurance and uninsured inpatient. The key research is the Insured Inpatient 's medical expense and their individual payment, To analysis the influencing factor in which the insured inpatient medical expense and individual expenses, to explore the trend of development about health insurance expense, to seek for the reasonable measure to control medical expense , to provide the science, reasonable, the feasible suggestion and the reference to the government of medical service support departments and the Medical establishment which formulate the health insurance policy. Methods: Using the review investigation and study method, collected 9382 example patient's medical record home page about 5 kinds of chronic disease (according to international illness sickness taxonomic approach, ICD-10) from two third-level of first-class general hospital on January 1st, 2003 - September 31, 2007. In those example patients who is being out of hospital , there are 4489 insured inpatient ,and 4893uninsured inpatient. Using the statistical description method and t-test to descript insurance and uninsured inpatient 's medical expense and the constitution; Using the factorial analysis method to study main control factors of insurance and uninsured inpatient 's each item expense; Using the spearman related analytic method to study the relation between insured inpatient's individual expenses and each item of expense; Using the t-test and one way ANOVA analytic method to study influence factor of insured patient's individual payment and fund payment. Results: 2003-2007 year the trend of per person in hospital expense about insurance and uninsured inpatient rises, and insured inpatient expense increased range is higher than the uninsured. The factorial analysis result showed that in insurance and uninsured inpatient 's expenditure, the proportion of drugs expense, inspection expense and the other expense becomes the important three parts in institutes account .5 kind of disease insured inpatient's expense is higher than the uninsured , expense of the insured patient who is get the disease of primary hypertension and chronic viral hepatitis is respectively amounts to 16263.65 Yuan and 9535.49 Yuan equally, Different disease its project costs accounts for the proportion to be different, but the proportion of drugs expense is greatly for its something in common. 2003-2007 year health insurance inpatient individual payment proportion drops year by year, the fund payment proportion rises year by year, Individual payment has good relation to the drugs, inspection, treatment and other expense in hospitalized expenditure (p<0.01). In the social factors , the sex, age, professional category are main factor affecting individual payment and fund payment of insurance inpatient (p<0.05). In the medical factors,,days in hospital, in hospital situation and treatment result are main factors affecting individual payment and fund payment to the insurance inpatient (p<0.05). Conclusions: During the practicing of the Medicare, medical expense rise has be control, insurance inpatient economic pressures has be reduced, growth rate of average per person expense of the health insurance patient has be slowed down, the drugs expense was under the control, the drugs expense is under the control, the proportion of the drugs expense to be lower than the uninsured inpatient ,but the inspection expense and other expense's control would be strengthened; average per person in hospital expense of insurance inpatient with chronic illness is higher than the uninsured inpatient, disease burdens of primary hypertension and chronic viral hepatitis is heavy. Reasonable controlled with drugs expense, the inspection expense and other expenses are key to control the insurance inpatient expense and individual payment, it is also the key point to lighten chronic illness disease burden. Sex, age, occupation, in hospital days, in hospital situation , treatment result etc. are main factors affecting individual payment and fund payment .It must have controlled medical expense which pay from the old age retirees, long days in hospital or seriously injured patient And from the macroscopic angle for the government health insurance department, the Medical establishment and individual tripartite control insurance inpatient medical expense . And from the macroscopic angle, put forward proposal and countermeasure for"the government the health insurance department, the Medical establishment and individual"tripartite control health insurance patient medical expense.