Study Of Direct Economic Burden Of Elderly In-patients For Hip Fracture In Different Medical Security Systems

BackgroundWith China's social and economic development, China has an ageing society. Human aging causes the fracture risk of osteoporosis and increase gradually. The most common osteoporotic fracture sites are the spine, distal radius and hip, of which hip fracture causes the most serious consequences. Osteoporosis and osteoporotic fracture because its much complications, disability and high mortality rate make the patient's quality of life level declined obviously. Osteoporotic hip fracture is becoming an issue of medical health and social health world wide with increasing importance. It is of critical importance to satisfy the basic health needs of the elders to the utmost, under the circumstance of limitation of medical resources.ObjectivesThis study based on the previous situation in different medical security system in partial areas of Guangdong province. Further, measures to effectively control medical cost and reduce patients'financial burden on medical health were probed. To offer reference and basis constantly improve the social health insurance system in our province.Methods1. Literature analysis methodAnalyze guangdong province and state the basic social medical insurance main policy and management methods. Focuses on analyzing medical security benefits and elderly medical costs management control related policies, documents and measures.2. Quantitative analysis methodAnalysis of Guangzhou, Huizhou and Zhuhai municipal medical insurance operation basic situation. Aged patients hospitalized with hip fracture personal medical burden. 3.Questionnaire survey(1) Health care workers questionnaire survey.(2) The patient and their families questionnaire survey.4. Data manipulationData of the aged patients hospitalized with hip fracture were processed. We associated their insurance record with their expense record for hospitalization by patients'personal code in medical security system, and then screened for useful information related to our study. Data base of our study was established and univariate descriptive analysis was processed. Questionnaire survey and analysis.Result1. Hospitalization cost analysis resultsThe mainly cost of elderly patients with hip fracture concentrated in medicine and treatment. Surgical instruments and drug cost most medical resources of hospitalized.2. Medical policy analysis resultsCompare with the payout of hostpital insurance in Huizhou and Zhuhai, the payout is higher in Guangzhou. But the hostipal insuranc fund pays a high proportion in Guangzhou, therefore, individuals can pay a lower percentage.3. Questionnaire analysis results(1) The patient and their families questionnaire analysis resultsMost respondents think the reason causes the heavy personal hospitalization economic burden is the high self-pay of surgery objects and related consumables built-in fee and drug costs.50.6% of respondents think the medical equipment shortages of grassroots health services of the community cannot satisfy the basic medical need. About 57 percent of respondents think the difference in individual pays proportion of different medical security system cause the self-pay excessively high or low.31 percent of Respondents think the health insurance cannot be used cross-regional makes the old from other area unable to enjoy health-care; 25 percent of respondents said the burden of hospitalization fees have an important effect in their family economic.53 percent of respondents said that the hospital expenses is bearable, although influencing their family economic. Only 17 percent of respondents said the burden of hospitalization fees make not significant affect to their family economic. (2) Health care workers questionnaire analysis results70 percent of respondents think the most main reasons causing old bone and joint disease patients who take a part in medical insurance to suffer overburdened Medical expenses are the high price of surgery built-in thing and related consumables and the big proportion of self-pay.74 percent of respondents think the shortage of grassroots health service organization medical equipment cannot meet the basic needs of medical treatment.44 percent of those surveyed said the short of integral environment of community grassroots health service organization affects patients to see a doctor.85% of respondents consider the difference in individual pays proportion of different medical security system cause the self-pay Excessively high or low.ConelusionA combination of the analysis results. The main reasons causing elderly patients with hip fracture take a part in medical insurance to suffer overburdened Medical expenses are the high price of surgery built-in thing and related consumables and the big proportion of self-pay. The shortage of grassroots health service organization medical equipment cannot meet the basic needs of medical treatment. The difference in individual pays proportion of different medical security system cause the self-pay excessively high or low. The health insurance cannot be used cross-regional makes the old from other area unable to enjoy health-care. To make sure the overall fund functions normally, increasing participants in medical security system and investment from the government, reducing medical expense are effective ways. Strengthening the supervision of drugs and medical devices management is a critical measure to control medical costs and to reduce the financial burden of the elder patients. Other measures that also make sense to reduce social health care burden include further development of community health services, abolishing district restrictions of health care, expanding cover scope of chronic diseases, and establishing a wholesome social medical security system.