常见慢性病住院费用与医疗保险报销的典型相关分析

Canonical Correlation Analysis on Hospital Costs and Medical Insurance Reimbursement of Common Chronic Disease

目的探讨常见慢性病住院费用消费与医疗保险报销支付之间的关系,为制定完善慢性病的医疗保险政策提供参考。方法应用典型相关分析了江苏省某市2010年5种慢性病患者13 289例的住院费用及医疗保险报销情况。结果住院医疗费用消费变量组载荷权数较大的是目录外药品费、目录外诊疗检查费、乙类诊疗检查费,而医保支付变量组载荷权数较大的是个人现金支付以及自费费用。影响慢性病患者个人现金支付以及自费的关键因素是住院患者的目录外药品费、目录外诊疗检查费、乙类诊疗检查费。结论适当扩大补充甲乙类药品及甲乙类诊疗检查目录范围;在病程管理上,对不同的慢性病患者应进行针对性、精细化分类管理。

Objective To analyze the relationship between hospital costs and medical insurance reimbursement of com- mon chronic diseases, so as to provide a reference for the development of chronic disease medical insurance policy. Methods There were 13 289 patients with chronic disease in a city of Jiangsu province in 2010 included in our study. Canonical correlation analysis was applied to evaluate the relationships between hospital costs and medical insurance reimbursement. Results The vari- ables with largest weights in hospital expense were expense for non - essential drugs, expense for non - essential diagnosis and treatment, and expense for B - class diagnosis and treatment; while the variables with largest weights in medical insurance reim- bursement were personal - paid expenses in cash and out - of - pocket expenses. The key influential factors of personal - paid ex- penses in cash and out - of - pocket expenses in hospitalized patients with chronic disease were expense for non - essential drugs, expense for non - essential diagnosis and treatment, and expense for B - class diagnosis and treatment. Conclusion The lists of medicine and diagnosis and treatment of Class A and B should be expanded appropriately ; and to improve the management of the disease, patients with different chronic diseases should be classified accordingly.