社会医疗保险制度对糖尿病患者住院费用的影响研究

The Study of the Influence of the Social Medical Insurance System on the Hospitalization Expenses for Diabetes Mellitus

目的 研究社会医疗保险制度对糖尿病患者住院费用的影响 ,为合理的医疗体制改革提供理论依据。方法 收集江苏省镇江市某三级医院 1997— 2 0 0 1年间糖尿病病例共 14 32例 ,按患者支付住院费用的性质分为公费组共 115例、社会医疗保险组共 95 3例和自费组共 36 4例。分析 5年间住院天数、住院总费用、床位费、药费、检查费、治疗费、其他费用、疾病病死率和疾病好转率在三者间的差异 ,同时分别对各组 1997— 2 0 0 1年每一年的住院天数和住院各项费用进行比较。结果 公费组和社会医疗保险组的住院天数、住院总费用、床位费、药费、检查费、治疗费、其他费用均比自费组明显增多 (P <0 .0 0 1) ,且公费组又比社会医疗保险组明显增多 (P <0 .0 0 1)。但糖尿病病死率、好转率在三组间并无显著性差异 (P >0 .0 5 )。公费组的住院费用有逐年上升趋势 ,而自费组和社会医疗保险组却无明显增加。结论 社会医疗保险制度可以有效遏制糖尿病患者医疗费用的上涨 ,有利于医疗资源的节约 ,但仍然存在一定缺陷 。

Objective To study the influence of the social medical insurance system on the hospitalization expenses for diabetes mellitus and to provide the theoretical basis for the reasonable reform of medical system. Methods 1432 diabetes mellitus patients from one of the 3th class hospital in Zhenjiang, Jiangsu province between 1997 and 2001 were divided into public medical expenses group, social medical insurance expenses group and paying their own expenses group by the character of paying medical expenses and their numbers were respectively 115, 953 and 364 cases. The difference of day of hospitalization, total cost, bed cost, drug cost, examination cost, therapy cost and so on, disease fatality rate and disease improvement rate between three groups during five years were analyzed. The annual day of hospitalization, cost of hospitalization in every group between 1997 and 2001 were compared. Results The day of hospitalization, total cost, bed cost, drug cost, examination cost, therapy cost and so on in public medical expenses group, social medical insurance expenses group were significantly higher than those in paying their own expenses group(P<0.001).And these costs in public medical expenses group were also signifi cantly higher than those in social medical insurance expenses group(P<0.001). But the fatality rate and improvement rate in DM patients among three groups were no significantly different(P>0.05).The cost of hospitalization in public medical expenses group was on the rise year by year, but that in social medical insurance expenses group and in paying their own expenses group had no significantly increase. Conclusion The increase of medical cost in DM could be controlled through the social medical insurance system, and the medical resources could be saved. But the system had also some defect, and need to be improved. [