Study On Comparison Of Hospitalization Expenses Between The Insured And Uninsured Patients And Their Influencing Factors In The Third Grade First-class Hospital

ObjectivesThrough statistical analysis of the data included hospitalization expenses between the insured and the uninsured inpatients from the third Grade first-class hospital in Kunming, we understood the differences of two groups, and knew the proportion, variation tendency and influencing factors of hospitalization costs in depth, simultaneously analyzed the main causes of unreasonable growth of inpatient expenses, to supply references of the hospital administrators to set up the measures on controlling the costs of insured inpatient, meanwhile, The study could proposed the reasonable ideas and suggestions on the establishment of the payment criterion of local DRGs for the medical care administrative department and medical insurance organizations.MethodsBy using retrospective study; workload of medical, chose the largest third Grade first-class general hospital in this province, we collected2,403valid data in this hospital from August2007to December2011. We searched the socioeconomic characteristics, disease characteristics; the quality of diagnosis and treatment based on the first pages of all inpatients’medical records, and received their hospitalization costs from hospital information center. All the data was set up a database of Epidata3.1, and analyzed through SPSS21.0, analyzed by statistics ways such as descriptive study, chi-square test, rank sum test, linear correlation and multiple stepwise regression analysis.Results1. the hospitalization expenses of the insured and the uninsured inpatients showed a rising trend from2007to2011.2. At the total cost of inpatients, median costs of hospitalization of the insured group(9690.66) are higher than those of the uninsured group (8421.46)(P<0.001).3. At the composition of hospitalization cost, the top two fees of the insured group and uninsured group are drug expenses and examination inspection fee.4. The average recovery period is higher than the average level (12.4days) of the national third Grade hospital.5. The main hospitalization expenses influencing factors of insured group were the ratio of the examination cost, treatment period, whether do operation, nursing level, and whether to use insured medicine, age, etc. The main factors which affect hospitalization expenses of uninsured group are treatment period, the ratio of examination cost, save times, the ratio of examination and technology and age, etc. It is worth that the ratio of the examination cost has a significant affect of the overall hospitalization expense, the insured group and uninsured group.Conclusions1. Pay more efforts to control the unreasonable growth of hospitalization expense.2. The payment mode had an effect on Medical expenses, we should consummate the medical insurance system, improve the mode of medical payment.3. To strengthen the control of drug expenses, examinations, inspection fee and radiation costs. 4. The effective measures should be taken to shorten the average treatment period.5. According to the characteristics of different groups, the direction of the control measures should be reinforced so that the objectives of health policy can be achieved early.6. DRGs is an effective way to promote the hospital scientific management, reasonable examination and find reasonable treatment process.