Medical Expenses Of Hepatitis C And Analysis Of Influence Of Rural Residents Of A County In Liaoning Province

Objective: To investigate and analyze hospitalization medical expenses and household medicine expenses of hepatitis C’s patients among new rural cooperative medical system(NCMS), and study the expenses level of hospitalization medical and household medicine of hepatitis C patients in a county, and analyze influence of hospitalization expenses and household income and expenditure with hepatitis C, so as to provide the basis for reduce the heavy burden of medical expenses with hepatitis C.Methods: Choose all the inpatients with hepatitis C(n=538) in NCMS hospital database of 2010-2012 and patients who have hepatitis C(n=384) and those who do not have hepatitis C(n=596) in the county of Liaoning province, gather the family economic status of hepatitis C patients, medical expenses of hepatitis C and relevant data by using questionnaire survey, analyze hospitalization rate of hepatitis C patients, hospitalization expense and their distribution, influence of hospitalization expenses and household income and expenditure with hepatitis C, compensation of NCMS, household medical expenses of patients who have HCV and those who do not have by spss17.0 and spss20.0. Multiple stepwise regressions are used for analyzing hospital expenses of hepatitis C; analyze the influence of different household income of catastrophic expenditure by Kruskal-Wallis H.Results: The proportion of hospitalization expenses and the per capita net income of rural residents in 2010 are 101.56%, as proportion of hospitalization are cut down, the average hospitalization in 2012 were cut down, analyzing the expenses of treatment of hepatitis C by the five equal in balance of family income per capital, proportion of expenses of treatment and income per capita in lower income family are 616.29%; it shows the medical expense has a large proportion in low income families, brings more economic burden, especially in low income families. 44.74% low income families causes catastrophic expenditure because of HCV, it is 30 percent higher than high income families. Therefore, besides the burden of hospitalization expenses, expenses ofmedical bought by their selves take great influence to family income. Proportion of medical expenses of patients with hepatitis C per year and household income per capita was 71.99%. Add this part, medical expenses of patients with hepatitis C take heavy economic burden of family. Patients of NCMS with hepatitis C from 2010 to 2012, medical expenses in the medical institution at county are lower than medical institutions outside the county, proportion of compensation are higher than medical institution outside the county, the proportion of compensation in the township health hospital are 72%; the hospitalization expenses were the highest in the outside the county. Medical expenses of medical institutions outside the county are 1.44-1.61 times to medical institutions at the county level, 3.84-4.86 times to medical institutions at township level; the proportion of compensation is low, at 49.75%.the hospitalization expenses paid by their selves are lower after compensation of NCMS, it reduce part of medical burden of patients with hepatitis C, but the households of medical burden is still heavy for families with hepatitis C patients, especially the proportion of medical expenses paid by patients themselves in lower income family and income per capita are 467%.Conclusion:The medical expenses for patients of hepatitis C bring heavy economic burden to their families and it cause greater influence to lower income families. The catastrophic expenditure rate is higher. In low income family, the proportion of medical expenses and household income of patients with hepatitis C is 171.59%. The level of medical institution has huge influence to hepatitis C expenses, the higher the level of medical institutions, the more the hospitalization expenses are, and the lower the proportion of compensation is. After compensation of NCMS, The proportion of hospital cost accounting for the county per capita income of farmers declined, but according to the results of household survey, the incidence of catastrophic expenditure is 28.13%, in low income families its 44.74%, it shows the economic burden of family medical expenses of hepatitis C patients in lower income are heavier. Besides the burden of hospitalization expenses, expenses of medical bought by their selves take great influence to family income. Add this part, medical expenses of patients with hepatitis C take heavy economic burden of family.According to medical reform guiding “cure serious illness in the county”. Strengthen the support of diagnosis and treatment of hepatitis C in the area of medical institutions at the county level, improve the quality of medical, make more patients with hepatitis C in treatment at medical institutions in the county, use compensation of NCMS reasonable, reduce medical expenses of patients of hepatitis C in some degree.