Analysis Of Urban And Rural Inpatients' Diseases Composition And Expenses In A Tertiary Hospital

Objective:Comparisons were made as to inpatients'diseases composition and hospitalization expenses of those who have been incorporated into Medical insurance for urban residents (hereinafter referred to as residents medical insurance) and New Rural Cooperative Medical System(hereinafter referred to as NRCMS) in a tertiary hospital. Disease types, hospitalization expenses and influencing factors in provincial hospital on the part of patients with two different kinds of medicare system were analyzed for the reference of the perfection of urban and rural medical insurance system and graded diagnosis and treatment.Method:1. Case records of 25704 urban and rural inpatients admitted into a provincial tertiary hospital in 2013 were selected, among which 5755 were with residents medical insurance and 19949 with NRCMS. Descriptive statistics and non-parametric statistical method were employed to analyze the distinction and influencing factors of diseases composition, departments distribution, hospitalization expenditure breakdown, medical expenses payment, and coronary heart disease expenses; 2. Rural and urban pediatric pneumonia patients aged 0 to 14 years old hospitalized from 2011 to 2013 in a provincial tertiary hospital were selected, among which 425 were with residents medical insurance, and 339 were with NRCMS. Case data during hospitalization were collected, single factor and multiple stepwise regression were used to analyze the influencing factors of medical expenses and different modes of payment on the part or rural and urban pediatric pneumonia patients.Result:Inpatients covered by residents medical insurance and NRCMS display distinctive features in terms of diseases types and department distribution. There is statistical difference regarding different departments and diseases (P<0.05); NRCMS patients generally spend more than patients with residents medical insurance in terms of total hospitalization costs, drug bill, material and other related expenses, laboratory fee, treatment fee, inspection fee and surgery charge, and there is statistical difference (P<0.05); As to the ratio of fund payment and individual payment, NRCMS is higher than residents medical insurance with statistical difference(P<0.05). Average hospital expenses for Pneumonia patients who are covered by residents medical insurance are 4055.79 yuan, NRCMS patients pay 4749.17yuan, with statistical difference. After single factor multiple stepwise regression analysis, hospitalization duration, disease feature, medical insurance type are the influencing factors of medical expenses and individual payment.Conclusion:Provincial Hospital of urban and rural residents hospitalized patients and hospitalization expenses compared the differences, medical insurance for urban residents in patients with pediatric diseases ranked the first, new rural cooperative medical care to malignant tumors in patients with lung cancer most. Residents of Medicare patients hospitalization cost was lower than that in the new rural cooperative medical care system. Medical expenses was mainly composed of medicine, material and other fees, examination fees, treatment fees, laboratory fees; main influencing factors of hospitalization expenses for hospitalization, disease characteristics, Medicare type; reduce hospital cost control of hospitalization, drug control, materials and other costs especially high value consumables, develop clinical path specification, implementation of medical grade, improve a unified urban and rural medical Safeguard and other comprehensive measures.