基于非参检验及多元回归分析的不同医保医疗费用自付比例研究——以成都市某医院Ⅱ型糖尿病患者为例

Research on Proportion of Out-of-Pocket Medical Expenses Based on Non-parametric Test and Multivariate Regression

医保改革和医疗费用是重要民生问题,人们关注不同医保类型的医疗费用自付比例是否存在差异和医疗费用自付比例的影响因素。基于此,本文用排列检验方法和交互效应模型,分析四川省成都市某三级甲等医院2020年1月至2021年12月内分泌科的Ⅱ型糖尿病患者的出院结算数据,探究城乡居民医保患者和城镇职工医保患者的医疗费用自付比例是否有显著差异以及医疗费用自付比例的影响因素,为医保的后续改革提供依据。研究结果发现2种医保患者的医疗费用自付比例有显著差异,检查费用比例等多种费用比例的增加会增加医疗费用自付比例;在低维情况下,本文所使用的高维排列检验方法与Hotelling T^(2)排列检验的结果一致。

Medical insurance reform and medical expenses are people’s important livelihood issues.People pay attention to whether there are differences in the proportion of medical expenses paid by different types of medical insurance and the influencing factors of medical expenses.In this paper,the discharge settlement data of type 2 diabetes patients in the secretion department of a tertiary class-Ⅲ-A hospital in Chengdu,Sichuan Province are analyzed from January 2020 to December 2021 by using the high-dimensional permutation test and the interaction effect model to explore whether there is a significant difference in the medical expense out-of-pocket ratio between urban and rural resident medical insurance patients and urban employee medical insurance patients and the influencing factors of the medical expense out-of-pocket ratio,so as to provide a basis for the subsequent reform of medical insurance.The results of the study show that there are significant differences in the medical expense out-of-pocket ratio of patients with two types of medical insurance,and the increase of various expense ratios such as examination expense ratio would increase the medical expense out-of-pocket ratio.Moreover,under low dimensions,the results of the high-dimensional permutation test method used in this paper are consistent with those of the Hotelling T^(2) permutation test.