Study On The Influence Of Health Poverty Alleviation Policy On The Hospitalization Expenses Of Patients With Coronary Heart Disease In Rural Areas In Anhui Province

Objectives Took the hospitalization expenses of patients with coronary heart disease as an example.Analyzed the influences of health poverty alleviation on the level of hospitalization expenses,the structure of hospitalization expenses and the proportion of reimbursement in Anhui province.Explored influencing factors of hospitalization expenses and clarified the stakeholders and their interactions,then put forward the pertinent suggestions.It helped to provide references for the further promotion of health poverty alleviation work.Methods Took the hospitalization expenses of patients with coronary heart disease as an example.The subjects were divided into the non-impoverished group(not enjoying the health poverty alleviation policy)and the impoverished group(enjoying the health poverty alleviation policy)according to if they enjoyed the health poverty alleviation policy.181 cases of non-impoverished group and 172 cases in the impoverished group were collected from a Third Grade Class A Hospital by field investigation.SPSS 18.0was used to carry out two independent samples t test,?~2 test and Ordinal and multi-classification regression analysis to analyze data.The stakeholders and their interactions were analyzed by methods of stakeholder analysis and interview.Suggestions were provided according to the results of study.Results(1)The average hospitalization expense in the non-impoverished group was 45129.771±3897.926 yuan,the average hospitalization expense in the impoverished group was51217.062±18339.713 yuan.The average hospitalization expense in the impoverished group was higher than that in the non-impoverished group(P<0.05).(2)Compared with the non-impoverished group,the proportion of material cost,treatment and nursing cost of the impoverished group increased by 0.56%and 0.18%respectively.The proportion of operation and anaesthesia cost,inspection and laboratory cost and drug cost decreased by 0.08%,0.08%and 0.58%respectively.The proportion of other expenses remained unchanged.(3)The rate of expenses that can be reimbursed in the non-impoverished group and impoverished group were 73.67%±12.44%and 69.89%±11.86%respectively.The rate of expenses that can be reimbursed of impoverished group was lower than the non-impoverished group.(4)The proportion of health insurance payment and out of pocket of non-impoverished group were 49.58%±8.01%and 50.42%±8.01%respectively.The proportion of health insurance payment and out of pocket of non-impoverished group were 88.43%±12.81%and 11.57%±12.81%respectively.The proportion of out of pocket of impoverished group was much lower than the non-impoverished group,the proportion of health insurance payment was higher than non-impoverished group.(5)The discharge outcomes between two groups were no significant difference(P>0.05).The length of stay of impoverished group(7.663±2.888 days)was longer than the non-impoverished group(6.961±2.339 days)(P<0.05).The length of days after operation of impoverished group hospitalization(4.494±2.318 days)was longer than the non-impoverished group(3.867±1.872 days)(P<0.05).There was no significant difference of the days before operation and stents between two groups(P>0.05).(6)Keep other variables unchanged,if patients'hospitalization expense are increased by one or more grades.In the non-impoverished group,the risk of Southern Anhui was3.212 times of Northern Anhui;if we increased one stent,the risk increased by 4.388times.In the impoverished group,the risk of middle Anhui was 0.470 times of Northern Anhui;if we increased one stent,the risk increased by 7.592 times;if hospitalization days increased one day,the risk increased by 0.171 times;if the days after operation increased one day,the risk increased by 0.591 times.(7)There are two sides of interaction among patients,the doctors,the government and the medical insurance.(8)We should improve poverty alleviation policy,it will helps to ensure the health poverty alleviation.Establish linkage mechanism and unify four stakeholders.Seize the key factors to promote the accuracy of health poverty alleviation.Conclusions After receiving health poverty alleviation policy,the average hospitalization expense of rural impoverished coronary heart disease patients was higher than that of rural non-impoverished coronary heart disease patients who did not accept the health poverty alleviation policy,and the proportion of out of pocket was lower than that of the rural non-impoverished coronary heart disease patients who did not accept the health poverty alleviation policy.The health poverty alleviation policy is not conducive to the optimization of the structure of hospitalization.The proportion of material expenses in the hospitalization expenses of the rural impoverished coronary heart disease patients is high under the health poverty alleviation policy.Improving the policy of poverty alleviation,making positive interaction of stakeholders and grasping the key factors to carry out healthy poverty alleviation accurately and so on.The above measures are of great significances for health poverty alleviation.