Analysis Of Medical Expenses Of Cesarean Section Patients In Tertiary Hospitals In China From The Perspective Of Medical Insurance Payment

Objective: The rising cost of medical and health care has brought great economic burden to people.Strengthening the research on medical expenses and exploring the main factors that affect the rise of medical expenses are effective ways to make reasonable control of medical expenses.However,the hospitalization expenses under different medical insurance payment methods are also quite different.It is necessary to compare the differences between different medical insurance payment methods in different regions of China.Through the analysis of the medical expenses of the inpatients of cesarean section in the third level hospital of our country,we can master the composition of the hospitalization expenses,and use the analysis of variance and stepwise multiple regression analysis to analyze the main influencing factors of the hospitalization expenses of the patients,find the most important influencing factors of the hospitalization expenses,and on this basis,we can distribute and utilize the limited health resources fairly and reasonably for our benefit To provide reference for the reform of national medical insurance.Methods: through literature research,this study understood the current situation of hospitalization expenses and influencing factors of cesarean section patients in China,and the status of medical insurance payment mode of cesarean section;through qualitative interviews with clinical experts and medical insurance staff in the sample cities included in this study,we learned the difference of hospitalization expenses and influencing factors of cesarean section patients in different regions,and the medical insurance expenditure of cesarean section patients in different regions Pay the status quo;and take the information of the inpatients of cesarean delivery in the tertiary hospitals of China from January 1,2017 to December 31,2017 as an example,use variance analysis and stepwise multiple regression analysis to analyze the influencing factors of the data,and combine the characteristics of medical expenses composition to reasonably elaborate the analysis data results;use access to establish the database,and use Stata statistical software to analyze the data Carry out corresponding statistical analysis.Result:1.This study analyzed 5069 inpatients of cesarean section in tertiary hospitals of China in 2017.The average age of the patients was 31.18 ± 4.95 years old,3746 were 20-34 years old(maternal age),accounting for 73.90% of the total;3440 were more residents,accounting for 67.86%;2872 were more inpatients in central areas than other areas,accounting for 56.66%;3565 were more inpatients at Prefecture and city levels,accounting for 21.66%;The number of inpatients in third tier cities is 3134,accounting for 61.83%;the number of inpatients in general hospitals is 4292,accounting for 84.67%;the number of inpatients paid by head is 1538,accounting for 30.34%;the number of premature patients is 3593,accounting for 70.88%.2.In this study,the average hospitalization days of cesarean section patients were 6.3 ± 3.3 days,and the average hospitalization cost of patients was 8733.3 ± 3822.1 yuan,of which,the drug cost was 2003.3 ± 2238.2 yuan,accounting for 22.9% of the total cost,followed by the operation cost of 1883.1 ± 1305.7 yuan,accounting for 21.6%,and the minimum nursing cost was 171.4 ± 182.3 yuan,accounting for 2.0%.3.Among the different age groups,the total hospitalization expenses of the elderly maternal patients are 9279.7 yuan;among the different city levels,the average hospitalization expenses of the patients in the new first tier cities are 10868.3 yuan;among the different medical insurance payment methods,the average hospitalization expenses of the patients under the service unit payment method are significantly higher than those of the other payment methods,10665.6 yuan,and the expenses under the capitation method are the lowest,It was 7569.7 yuan,and there were statistically significant differences in hospitalization days,different age groups,insurance types,city categories,different city grades,hospital nature,different medical insurance payment methods and whether premature delivery or not(P < 0.001).4.Stepwise multiple regression analysis of the data showed that there were statistically significant differences(P < 0.001)in hospitalization days,city level,medical insurance payment method,insurance type and age.Among them,hospitalization days were the main factors affecting hospitalization expenses,followed by city level,medical insurance payment method,insurance type and age.5.According to data analysis and data review,the cost of cesarean section varies greatly in different regions of China,and the payment methods of medical insurance are also different.The cities with higher cost are mostly in the second tier cities;and under the same level of cities,the inpatient cost paid by capitation or by disease is lower than that paid by service items or by service unit Patients.Conclusion: in the analysis of the main influencing factors of the hospitalization expenses of cesarean section patients in this study,the hospitalization days were the most important influencing factors;different age groups,insurance types,different city levels,different medical insurance payment methods had statistical differences in the hospitalization expenses of cesarean section(P < 0.001).The main reasons for the increase are the long hospitalization days,the high proportion of medical expenses and the unreasonable payment of medical insurance.Therefore,reducing the hospitalization days,changing the structure of medical expenses,reforming the payment method of medical insurance and controlling the rate of cesarean section are effective measures to reduce the hospitalization of cesarean section patients.