Research On Impact Factors Of Hospitalization Expense For Farmers Participating NRCMS In Gansu’s Wushan County

Background:With the excessive increasing of total health expenditure in the whole world, it becomes a heavy financial burden and research hotspot, so does it in China. The hospitalization expense needs to be the start for the analysis of growth factors on medical costs, exploration of these reasons and controlling strategies, for the aims on relieving the medical expenditure’s excessive growth, reducing the residents of disease burden and rational use of health resources. The New Rural Cooperative Medical System (NRCMS) reduces the farmers’ diseases burden and improves their ability to resist diseases risk to some extent, however, for it’s limits on the fund-raising and commensuration efforts and the raising costs of hospitalization expenditure, there are still quite large farmers who need to take most of the hospitalization expenditure and face with the expensive medical spending problems. Therefore, the research on impact factors of hospitalization expenditure for the NRCMS participating farmers has important implications for improving the effective use of health resources and the NRCMS.Objectives:Through the analysis on the hospitalization expenditure of the NRCMS participating farmers in Wushan County, Gansu Province, the aims are, Firstly, to understand the constitutions of hospitalization expenditure, medical expenditure and compensation situation and to summarize the distribution and characteristics of expenditure and compensation; Secondly, to explore the impact factors on diseases’ economic burden and hospitalization expenses based on the comprehensive understanding the current situation in Wushan County; Finally, to explore the NCMS funding utilization and compensation reasonable for participating farmers in Wushan county and provide strategies and political mechanism advices.Methods:The hospitalized patients, hospitalization expenditure and compensation information were gotten from Wushan county NCMS Medicare database, and the patients’ records and medical expenditure in2012who participated the NCMS are the research objectives. The database was established by Excel2010after excluding the records with missing information. SPSS17.0software was used to analyze the general distributions and structures of hospitalization diseases, in-patients, related diseases, hospitalization expenses and compensation by the descriptive statistics, univariate analysis, multivariate analysis methods.Results:1. The gender, age, and difference hospitals make influential roles on the hospitalization expenditure:the males’expenditure are more than the female, and the expenditure increased by the higher aging and hospitals level;2. In the hospitalization expenditure, the medicine costs(including traditional Chinese medicine and clinical medicine costs) and surgery costs were the highest reaching to74.03%;3. The in-patient day is an important factor for NCMS participating farmers hospitalization expense, and the expense was increasing by more days of inpatient;4. The actual amount of compensation is the most important factor affecting hospitalization expenditure, whose review coefficient is0.755. The participating farmers actual compensation ratio was still quite lower than the policy’s requirement, and the diseases burden is still heavy.Suggestions:1. Primary health care need to be strengthened on institution-building, hardware investment, talent introduction, deepening the referral system and policies and institutions which can be benefit for the primary health institution. Patients need to be leaded to the primary hospitals and then the hospitalization expense reduced.2. The disease prevention and health care need to be strengthened to the elderly, and more attention and investment need to be paid for the elderly health situation for protecting the elderly health;3. To control the excessive growth of drug prices by making the medicine prices specification and deepening the medicine reform;4. The hospital bed turnover rate and the utilization of health services need to be improved by scientific and reasonable shorten the average length of inpatient and unreasonable inpatient staying based on guaranteeing health services quality;5. The reimbursement of hospitalization expenses need to be improve effectively.