Cross Sectional Study On The Signal Disease Payment Of End-stage Renal Disease In A City Of Zhejiang

Objective:By investigating the health service utilization and the fee in2010, the signal diseases satisfaction of insured patients and interviewing the difficulties of medical insurance institution and certain hospitals during their carried out the signal disease policy, explore the reform measures of ESRD signal diseases and provide the reference and suggestion to the reform of signal diseases system in Hang Zhou.Methods:This study used retrospective survey to analysis the expense of the insured patients in2010. The study also used descriptive study to describe the expense of the insured patients and used Non-parameter test and multiple linear regression to analysis the influence factor of individual payment. The research used the self-designed satisfaction questionnaire of the signal disease payment to investigate257insured patients who were treated by dialysis therapy.Appraised the internal consistency reliability and construct validity through Cronbach’s Alpha and Factor Analysis. Non-parameter test and multiple linear regression were used to analyze the influence factors of satisfaction. All the analyses were conducted by SPSS17.0statistical software. the level test was set at a=0.05.Results:Hemodialysis expenses were majorly composed by treatment expenses, accounting for53.01%. Peritoneal Dialysis expenses were majorly composed by drug expenses, accounting for93.16%. The main influence factors of hemodialysis individual payment were the insured staff categories; whether added oxygen; whether Minimum living security patients; the times of HD and HDF using; whether having complications. The mean of insured patients satisfaction to hospitals were above the mean of satisfaction to signal diseases payment policies. Settlement contents in the payment policies got the lowest satisfaction mean.The main influence factors of total satisfaction were the treatment modality. The main influence factors of settlement range policies were treatments modality and family monthly average income. The higher family income of insured patients, the lower the signal diseases payment satisfaction. The main influence factors of policies satisfaction is settlement range and difficulty rescue policy. The medical environment and the medical device is the main influence factor of the satisfaction to hospitals.Conclusions:The study shows that in order to reform the signal diseases policies, effective measures should be taken,like Reasonable calculation payment criteria of signal diseases; adjustment the Settlement contents packaged payment of the medicine in need. Standardized the process of payment and build the criteria of entry and removal. The medical insurance department should extend the signal diseases policies to the patients who participated in other social medical insurances and expanded the disease category from ESRD to others.