| The incidence of virus hepatitis in China is very high. Hepatitis B and hepatitis C are the major two kinds of hepatitis in the Chinese population. If one be infected by the hepatitis virus, especially when the hepatitis changes to the chronic hepatitis, the treatment costs of patients are usually expensive. To make the people enjoy the medical resources and gain the essential medical services, China government has performed the medical insurance system renovation for less than 20 years. It should not be denied that the renovation had some positive effects on medical insurance system. When one suffer from an serious disease, the support of the medical insurance system has been the essential condition which decides the level of economic endurance and decides the popular how to allocate and make use of the limited medical resources efficiently and rationally. However, the medical insurance system renovation hasn't solve such problem, which make the patients can't share the medical resources rationally and can't lead an optimum balance between medical effects and economic costs.In the former researches concerning the medical costs of inpatients, the focuses of the research were usually laid on the factors of hospitalized length, syndrome, condition of hospitalization and hospital discharge, the times of examination. Less importance has been attached to the problem of the relation between the medical insurance code and medical costs. Owing to the reason as above, this paper included the case data of the inpatients with chronic hepatitis B or hepatitis C in the infectious hospital of Siping City and the hepatological disease hospital of Liaoyuan City , the No.1. Hospital of Jilin University during the period from 2008 to 2009. The investigation and analysis were focused on the common conditions, treatment conditions, medical insurance codes, hospitalization costs, medicine costs and examination costs. The Excel and SPSS 13.0 software were used to collect and analyze the data which were described statistically and analyzed preliminary by indexes of percentiles, quartiles, medians and extreme values.According to the including principles, this paper included 1031 inpatients, in which there were 843 chronic hepatitis B inpatients and 188 chronic hepatitis C inpatients.The investigation and analysis showed the results as below:1,In the included hepatitis B cases in the infectious hospital of Siping City and the hepatological disease hospital of Liaoyuan City,"the basic medical insurance for employees"code had higher distributions in total hospitalized costs and length, a lower distribution in daily hospitalized costs."the new rural cooperative medical insurance"code had lower distributions in total hospitalized costs and length, a higher distribution in daily hospitalized costs."medical insurance for urban inhabitants"and"own charge"codes had lower distributions in total hospitalized costs and higher distributions in hospitalized length and daily costs."the basic medical insurance for employees"code had higher distributions in examination costs and drug costs, while"the new rural cooperative medical insurance"code had a lower distribution."the basic medical insurance for employees"and"medical insurance for urban inhabitants"codes had higher distributions in total reimbursable hospitalized costs, while"the new rural cooperative medical insurance"code had a lower distribution."the basic medical insurance for employees"code had a highest distribution in reimbursable drug cost,"medical insurance for urban inhabitants"code had a lower distribution and"the new rural cooperative medical insurance"code had a lowest distribution."the basic medical insurance for employees"and"the new rural cooperative medical insurance"codes had higher distributions in reimbursable examination costs, while"medical insurance for urban inhabitants"code had a lower distribution. 2,In the included hepatitis C cases in the infectious hospital of Siping City and the hepatological disease hospital of Liaoyuan City,"the new rural cooperative medical insurance"and"own charge"codes had higher distributions in total hospitalized costs."medical insurance for urban inhabitants"code had a lower distribution in hospitalized length."own charge"code had a lower distribution in daily hospitalized costs and a highest distribution in examination costs."medical insurance for urban inhabitants"and"the new rural cooperative medical insurance"codes had lower distribution in examination costs, while"the basic medical insurance for employees"code had a lowest distribution."the new rural cooperative medical insurance"code had a higher distribution in drug costs."the basic medical insurance for employees"code had a higher distribution in total reimbursable hospitalized costs, while"medical insurance for urban inhabitants"code had a lower distribution."the basic medical insurance for employees"code had a higher distribution in reimbursable drug costs and a lower distribution in reimbursable examination costs, while"medical insurance for urban inhabitants"code had a lower distribution in reimbursable drug costs and a higher distribution in reimbursable examination costs.3,In the included hepatitis B cases in No.1 Hospital of Jilin University,"commercial insurance"code had a lower distribution in total hospitalized costs,"commercial insurance","own charge"and"others"codes had lower distributions in hospitalized length."socialized medicine","medical insurance"and"comprehensive arrangement for serious disease"codes had higher distributions in hospitalized length and lower distributions in daily hospitalized costs."comprehensive arrangement for serious disease"and"commercial insurance"codes had low distributions in examination costs."commercial insurance","own charge"and"others"codes had lower distributions in drug costs.4,In the included hepatitis C cases in No.1 Hospital of Jilin University,"own charge"code had a lower distribution in total hospitalized costs."comprehensive arrangement for serious disease"and"own charge"codes had lower distributions in hospitalized length and higher distributions in daily hospitalized costs."socialized medicine"and"medical insurance"codes had higher distributions in hospitalized length and lower distributions in daily hospitalized costs."comprehensive arrangement for serious disease"and"others"codes had lower distributions in examination costs."comprehensive arrangement for serious disease"and"own charge"codes had lower distributions in drug costs.According to the results as above, there are diversities in the distribution of the hospitalized costs of the chronic hepatitis B and hepatitis C inpatients with different medical insurance codes. It is should be said that the degrees in which the inpatients with different medical insurance codes make use of the medical resource are various. It also reflects the facts that the medical insurance system in China doesn't reach the aim of meeting the people medical needs and allocating the medical resources. Concerning this condition, the author proposed countermeasures as below to deepen the medical insurance system renovation.The management and allocation of medical insurance funds should be optimized. Institutional reform on the medical insurance system in China should be deepened. The treatment level of insured staff should be rectified reasonably.The medical insurance system renovation doesn't reach the aim of making advantages of the medical resources in case of safeguard the medical effects as be expected. The problems make the patients tread as on eggs or at loose ends. Therefore, not only the medical management institutes and medical supervised institutes, but also the hospitals which provide medical services should face with such conditions positively, while this will be a long-term and formidable mission. |
