福建省新农合超高额住院费用患者分布特征研究

Study on characteristics of case distribution of super-high hospitalization expenditure in Fujian NCMS

目的研究福建省新型农村合作医疗(新农合)超高额住院费用患者的主要分布特征。方法分析2010—2012年住院补偿数据库数据,对≥25万元超高额住院费用患者进行描述性分析与同质分析。结果超高额住院费用患者共401人次,在住院者中的比例为6.4/10万;在参合者中的发生率为0.55/10万,年递增率达27.5%;性别比=2.4∶1;55岁以上老人居多;主要分布于沿海;所患病种多为癌症;绝大多数在市级、省级住院,军区总院、省立医院和协和医院住院者居多。结论超高额住院费用患者数27.5%的惊人年递增率,应引起大病保险基金管理者的严重关切;控制超高额住院费用,省级医院应是重点。

Objective To study the case distribution characteristics of super-high hospitalization expenditure （SHHE） in Fujian NCMS. Methods To analyze the farmer＇s hospitalization database from 2010 to 2012 by descriptive study and homogeneity analysis （HOMALS）, focus on the SHHE cases （≥RMB 250 000 Yuan）. Results Totally 401 SHHE cases were in the three years, the proportion in hospitalization cases was 6.4/10s , the rate in farmers was 0.55/105 ,annual increasing rate was 27.5%, male： female = 2.4： 1, most of them were aged 55 and above. They hospitalized mostly suffering from cancer and at municipal or provincial levels, especially in General Hospital of Najing military area, Fujian Provincial and Union Hospital. Conclusion The administrators of NCMS should pay attention to the stupendous annual increasing rate （27.5%） of SHHE cases. The critical control point （CCP） of SHHE cases should focus on the hospitals at provincial level.