某三甲医院不同医保形式肾移植患者住院费用比较分析

Analysis of Medical Cost of Renal Transplant under Different Medical Insurance Policies in a Tertiary A Hospital

目的通过对尿毒症患者在院期间的花费进行回顾性分析,从而探究影响住院花费的因素以及不同医疗保险形式的患者住院费用的特点。方法资料来源于济南某三甲医院2011年1月-2013年1月收治220例尿毒症患者的相关信息,其中,城镇职工医疗保险患者110例,新农合患者110例。采用回顾性研究方法,进行统计学分析。结果医疗保险与新农合患者住院总费用之间有显著性差异(P<0.01)。医疗保险组的平均住院费用,以80岁以上组费用最高;新农合组的平均住院费用,以70~79岁组费用最高。不同医疗费用的患者各年龄组的住院平均费用均有统计学差异(P<0.01)。不同费用类别的患者其住院平均费用中,药费、检查费、治疗费以及床位费之间均存在显著性差异(P<0.05);药费部分的比例最高。结论加快医疗保险制度的改革,缩小城镇职工医保和农村合作医疗保险之间的差距,在保持和确保政府主导的基础上逐渐引入市场竞争机制。

Objective To identify the factors that influence the cost of hospitalization and find the characteristics of different payment methods by the new rural cooperative medical system or by medical insurance through the analysis of the cost of hospitalization of uremic patients.Methods A total of220cases were selected.The data was obtained from patients with a statistical information database in a hospital in Jinan between January2011and January2013.All the data was analyzed retrospectively.Results There was significant difference in the cost of hospitalization between payment by medical insurance and payment by the new rural cooperative medical system according to Independent-Sample T test(P<0.01).The average cost of hospitalization of the group of medical insurance patients above80years old was the highest,so was the average cost of hospitalization of patients aged70to79within the new rural cooperative medical system.The cost of hospitalization was significantly different between medical insurance and the new rural cooperative medical system in each age group(P<0.01).The constituent ratio of inpatient expenses was significantly different(P<0.05)between patients with medical insurance and those within the new rural cooperative medical system.The cost of drugs ranked first among hospitalization expenses.Conclusion The market mechanism should be introduced under the leadership of the government to speed up the reform of the medical insurance system and narrow the gap between the medical insurance for urban workers and rural cooperative medical insurance.