The Cost Of Inpatients With Stroke In Tertiary Medical Institutes In Tianjin

ObjectiveTo explore the effects of stroke inpatients on expenses, personal burden ratio and medical insurance policy in Tianjin. To find a way to using medical insurance fund rationally, controlling cost and reducing the personal economic burden ratio and the social economic burden of patients.Methodsselecting146826cases of medical insurance covered inpatients with stroke in tertiary medical institutes in Tianjin, observing the cost effects of different gender, age, diseases, hospitalization length and prognosis.Choosing26613patients in two medical institutions as sample, analysing personal burden ratio effects of different categories, disease. Using Excel2003and SPSS17software to process data.ResultsThe number of ischemic stroke patients was127090, significantly higher than that of hemorrhagic stroke patients. There were87666male patients, which accounted for59.71%of all the stroke patients and more than female ones. The average age of ischemic stroke patients was65.83±11.38years, older than that of hemorrhagic stroke patients. The total cost of ischemic stroke was over than1.8billion yuan, accounted for77.72%of the whole stroke economic burden. The average cost of hemorrhagic stroke was26100±33400yuan, higher than the cost of ischemic stroke. The number of old people inpatients with ischemic stroke was69074. accounting for47.04%of the whole stroke patient; and the cost of these patients was over than1billion yuan, accounted for55.99%of the whole stroke economic burden. The median length of hospitalization was14days and the median cost of hospitalization is12100yuan. The cost of hospitalization was positively correlated with the length of hospitalization. The medicine fee of hospitalization was over11billion yuan, more than any other fees, accounted for49.56%of the whole cost of inpatients. The average cost of death group was33900±20400yuan, higher than that of the cure group.The average cost of inpatients with stroke in two medical institutes was18700±21400yuan, higher than that of the tertiary medical institutes in Tianjin. For town inpatients, the average age was64.07＋11.44years, the average length of hospitalization was13.65±9.15days and the average cost of was18900±22600yuan. All of them were higher than that of the urban and rural inpatients. The personal burden rate in two medical institutions was49.20%, higher than that of the tertiary medical institutes in Tianjin. The personal burden of urban and rural inpatients was68.37%, which was higher than43.35%in town inpatients. The personal cost of town inpatients accounted for62.29%of the whole personal cost, which was higher than that of the urban and rural inpatients. For the urban and rural inpatients, policy cost accounted for56.38%of the whole personal cost, which was higher than that of town inpatients. For town inpatients, urban and rural inpatients, drug expenses which had the supreme effect on personal cost, were respectively27.31%,28.90%of the total personal cost. In the personal cost structure, the most important factors in turn were medicine fee, medical material fee, treatment fee and examination fee.ConclusionThe cost of male inpatients with ischemic stroke has a higher impact on the total disease economic burden; meanwhile the hemorrhagic stroke has a higher effect on personal burden compare with that of ischemic stroke. We should focus on the elderly patients with ischemic stroke, because the number and cost of those inpatients have a highest impact on stroke economic burden.The personal burden ratio of towns inpatients with stroke in two medical institutions is significantly higher than that of the tertiary medical institutes in Tianjin. Personal burden rate of rural patients is high, the structure is not reasonable. We should focus on the regulation of the cost of drugs and medical materials.