A Study Of Hospitalization Among Employees Participating In Urban Employee Basic Health Insurance Of Hunan Provincial-Level From2007to2009

Objective The main purposes of this study were to describe the status of hospitalization among employees participating in Urban Employee Basic Health Insurance of Hunan Provincial-Level from2007to2009, to analyze the main influencing factors of average hospitalization costs, to provide scientific data to further reform and better the Basic Health Insurance System.Methods A retrospective study was designed to analyze the status of hospitalization of insured employees and the main influencing factors of average hospitalization costs from2007to2009. Data were drawn from the Medical Insurance System’s Operational Database of Medical Insurance Center of Hunan Provincial-Level. We first described the status of hospitalization by population, and then analyze the main influencing factors of average hospitalization costs by subgroups. The classification of disease according to ICD-10was progressed. SPSS17.0was chosen for sorting and analysis.Results1. With the criterion of each record, a total of139217records were included.2. Among139217records, records in2007,2008,2009accounted for28.13%,33.05%,38.82%respectively; male57.25%and female42.75%; incumbency36.20%and retiree63.80%; civil servants17.10%and non-civil servants82.90%; three-grade hospital50.60%and non three-grade hospital49.4%. Discharge records in the second half of year accounted for52.5%. The average of age was60.7years, median64.0years. Hospitalization days in4days or less, within14days, within30days, more than60days accounted for5.00%,58.10%,90.60%,2.80%respectively, and the average hospitalization day was17.6, and median13.0. The top6diseases among the top50diseases of the number of discharge records were heart disease, lung infections, hypertension, cervical/lumbar disc herniation, cancers and diabetes consequently.3. The average yearly rate of hospitalization among the insured employee from2007to2009was15.55%, and13.96%,15.24%,17.27% respectively.4. The average hospitalization costs of per discharge record was8876.2Yuan, with a median of5629.1Yuan, and it totally showed the increasing upward tendency from2007to2009by subgroups.5. The average drug fee of per discharge record was4520.9Yuan, check fees1446.4Yuan, and diagnosis fees1274.1Yuan. All of them increased yearly from2007to2009. An average percentage of drug fees of per hospitalization costs was50.93%, and check fees, diagnosis fees were16.30%and16.30%respectively.6. The average hospitalization costs among insured employees might be affected by gender, age, retiree or not, civil servant or not, ranks of civil servant, length of stay, hospital ranks, outcome after leaving the hospital, operation or not, types of payment, categories of diseases, month of discharge and year of discharge.Conclusion1. The hospitalization rates of insured employees from2007to2009were higher.2. Drug fees had a higher proportion of the average hospitalization costs, and check fees had a lower proportion of the average hospitalization costs.3. Heart disease, lung infections, hypertension, cervical/lumbar disc herniation, diabetes were the top six categories of diseases, and most of them belonged to chronic diseases. It implied that the burden of chronic diseases may be heavy.4. The factors influencing the average hospitalization costs were multiple, and synthetic measures should be taken in the prevention and control of the rising hospitalization costs.