Medical Costs Of Mental Disorder Patients And Its Influencing Factors In Dalian

Objective:There are more than 83 million patients with mental disorders in our country, the high prevalence and low cure rate of mental disorders have brought serious harm to our society. The burden of mental disorders is at the first place in all the diseases, accounting for 20% of the total burden of disease, and it has become the heavy burden of our public health work, what's more it is increasing year by year. The purpose of this study is to find out the mental health care costs in Dalian and its related factors in order to reduce the economic burden of mental disorder patients and use the medical resource more reasonably.Methods:A cross-sectional study and retrospective surveys were conducted to find out the medical costs of the outpatient and inpatient as well as the related factors of the average hospitalization costs of schizophrenia and depression of mental health institutions in Dalian from 2007 to 2009. The medical costs of outpatient and inpatient were received from local health care by accessing to patient medical record subjects, the clinic prescription or by the finance department. The hospitalization costs and other general information of patients with schizophrenia and depression come from the seventh people's hospital in Dalian. Seeking data through the hospital HIS system,two common mental disorders on average cost of hospitalization and its influencing factors were studied.T-test, variance analysis and multiple linear regression analysis were used.Results:l.The outpatient visits, outpatient costs, outpatient drug fees, hospitalization times and hospitalization costs were increased year by year. Although the Per-time costs of clinic and hospitalization of the patients from rural areas were lower than those from urban areas, compared to the annual per capita net income, the economic burden of the rural patients were actually higher than that of the urban patients. Outpatient's drug costs accounted for 80%.2.The mental disorder patients had a high hospitalization rate. The patients who had three hospitalizations a year accounted for 15.6% of all the hospitalized patients, and four hospitalizations a year accounted for 11.3%. The patients who had been hospitalized three times a year and above accounted for 44.2% of all the hospitalized patients.3.The average Per-time costs of hospitalization of schizophrenia and depression were increased year by year. However, the costs of schizophrenia were higher than that of depression. Bed fees(27%), examination fees(22%) and treatment fees(21%) were listed as the top three parts in the hospitalization costs of schizophrenia, but the top three parts of depression were listed as drug fees(27%), medical fees(25%) and bed fees(21%).4.The main influencing factors of direct medical costs of schizophrenia included gender, the average length of stay, cost categories and prognosis. The female's medical costs of schizophrenia were higher than male's. Longer hospital stayed, higher hospital cost. The retired patients or civil patients were the highest, lowest cost was at their own expenses. Cured patients spent the highest cost. The main influencing factors of direct medical costs of depression included gender, the average length of stay, cost categories, comorbidity, prognosis, and marriage status (married). The male's medical costs of depression were higher than female's. Longer hospital stayed, higher hospital cost. The retired patients or civil patients were the highest, lowest cost was at their own expenses. The patients with comorbidity had higher costs than patients without comorbidity. Cured patients spent the highest costs. The costs of hospitalization of married people were higher than other ones.Conclusions:The medical costs of mental disorder patients in Dalian were high and increased year by year. The factors of average hospitalization costs of schizophrenia and depression were complex. A variety of treatments strategies should be carried out to reduce health care costs.