Analysis Of The Preventive Effect Of Basic Medical Insurance On Disastrous Medical Expenditure In China

Objective: ? Evaluation of the performance of China's basic medical security system for the prevention of disastrous medical expenditure.? To understand the present situation of disastrous medical expenditure in the families of hospitalized patients with myocardial infarction(Abbreviated myocardial infarction).Methods: ? A cluster sampling method was used to obtain the research object of myocardial infarction inpatients from October 1,2016 to October 31,2017 of a university affiliated three a hospital.? The longitudinal study conducted a questionnaire survey of the survey,the main contents include: using the self-made "family survey" were collected by a self-made family,"the basic personal situation questionnaire" to collect basic information of patients,using self-made questionnaire "and" hospital medical record management system through the query of illness and hospitalization expenses.? Analysis of factors affecting family disastrous medical expenditure by multiple factor Logistic regression.Results: ? A total of 500 valid questionnaires were collected,with an effective rate of 98.6%.? The urban workers' medical insurance reimbursement and commercial medical insurance reimbursement ratio is higher(70.9%,69.82%)was significantly higher than that of NCMS and urban residents' medical insurance reimbursement ratio(P<0.05);rural and urban residents' medical insurance reimbursement ratio was about 50%,there is no significant difference between the two(P>0.05).? The protection rate of medical insurance for urban workers and commercial medical insurance for catastrophic medical expenditure is higher than 70%,higher than that of urban residents and new rural cooperative medical insurance(P <0.05),but the protection rate of medical insurance for urban residents and NCMS is 50%.? The commercial medical insurance and urban workers' medical insurance had more than 50% protection for catastrophic medical expenditure,which was higher than that of urban residents and NCMS for catastrophic medical expenditure(P <0.05).? After multiple factors Logistic regression analysis to control other confounding factors:(1)There was no statistical relationship between individual characteristic variables,such as sex,age,marital status,education level,and disastrous medical expenditure(P >0.05);(2)There was no statistical difference in disastrous medical expenditure between different types of medical insurance(P >0.05);(3)The possibility of disastrous medical expenditure decreased as the economic level of the family increased(P<0.05);(4)The possibility of disastrous medical expenditure in patients with acute myocardial infarction was significantly higher than that of chronic(P<0.05);(5)Without treatment variables,the degree of myocardial infarction and hospitalization days were directly proportional to the occurrence of catastrophic medical expenditure(P <0.001).After adding the treatment variables,there was no statistical correlation between the degree of myocardial infarction and the length of stay(all P>0.05);(6)The cost of family disastrous medical treatment in the treatment group was significantly higher than that in the simple drug treatment group(P<0.05),but there was no significant difference in the disastrous medical expenditure between the families treated by simple drugs or general surgery(P>0.05);Conclusion: ? Medical insurance,NRCMS and urban residents' health insurance have a certain protective effect on catastrophic medical expenditure.The effect of medical insurance for urban workers is better and significantly higher than that of NCMS and urban residents.? Before medical insurance reimbursement,different medical insurance types have no effect on the disastrous medical expenditure in the families of hospitalized patients with myocardial infarction.? Families with low income,families with acute myocardial infarction and stent placement are more likely to have disastrous medical expenses than other families.Suggestions: the relevant government departments should increase funding for urban and rural residents health insurance,hospitalization expenses will be included in the low income of patients with myocardial infarction and acute myocardial infarction in patients with the illness insurance reimbursement range,according to the actual situation of the reform of ill Medicare reimbursement procedures,will be discharged after medical insurance center two reimbursement changes to discharge timely reimbursement...