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目的:调查两所三级甲等综合医院5种慢性疾病的住院费用情况,比较医保和非医保住院患者的住院费用及构成。方法:采用回顾性调查研究方法,收集乌市两所三级甲等综合型医院5年间住院出院的5种慢性疾病共计9 382例患者的病案首页,运用统计描述和t检验方法分析医保和非医保患者的人均住院费用及构成。结果:2003～2007年医保与非医保患者人均住院费用呈上升趋势,医保患者的人均住院费用高于非医保患者,人均住院费用平均增长速度分别为8.09%和6.36%,药品费、检查费和其他费与医保患者住院总费用关系密切,是构成住院总费用的主要成分。结论:合理控制药品费、检查费和其他费是控制医保患者住院费用和个人支付费用的关键,也是减轻慢性病患者疾病负担的重点。建议继续扩大医保覆盖面,提高保障力度,解决异地医保报销。
Objectives: To investigate the cost of hospitalization for five chronic diseases in two tertiary level A general hospitals and to compare the hospitalization costs and the composition of medical and non-medical insurance inpatients. Methods: A retrospective survey method was used to collect five cases of chronic diseases discharged from hospital in Urumqi, two tertiary hospitals in five years for a total of 9 382 patients. Statistical analysis and t-test were used to analyze the health insurance and non- Medicare patients per capita hospital costs and composition. Results: From 2003 to 2007, the per capita hospitalization expenses of medical insurance and non-medical insurance patients showed an upward trend. The per capita hospitalization expense of medical insurance patients was higher than that of non-medical insurance patients, and the average growth rate of per capita hospitalization expenses was 8.09% and 6.36% respectively. Drug expenses, examination fees and Other expenses are closely related to the total hospitalization expenses of medical insurance patients and constitute the main component of the total hospitalization expenses. Conclusion: Rational control of drug charges, examination fees and other fees is the key to controlling the hospitalization expenses and personal payment of Medicare patients, and is also the key point to reduce the burden of disease in patients with chronic diseases. Proposed to continue to expand coverage of health insurance to enhance security efforts to solve reimbursement of health insurance in different places.