Study On The Residents' Medical Expenditure And Its Influence Factors In Sichuan

Objectives Exploring the residents' medical expenditure in Sichuan province to provide the relevant baseline data for the health information system of Sichuan and probing into the medical expenditure influence factors of the residents over 15 years old to give some advices for the health reform in Sichuan.Methods Based on the data from the enlarged investigation in west China of the Third National Health Service Survey in Sichuan, this study described the residents' outpatient expenditure per-time in two weeks and inpatient expenditure per-time in a year. Intra-class correlation was used to decide whether the data is hierarchically structured or not. Then we explored the influence factors of the urban residents' inpatient expenditure with traditional multiple linear regression and the influence factors of the urban residents' oupatient expenditure with multilevel variance components model. Also with multilevel variance components model we discussed the influence factors of the rural residents' outpatient and inpatient expenditure.Results The average outpatient expenditure of the residents in Sichuan is 24.43 yuan. The urban residents' outpatient expenditure is 43.50 yuan and the rural residents' is 20.00 yuan. The average inpatient expenditure of the residents in Sichuan is 1201.83 yuan. The urban residents' inpatient expenditure is 2500.00 yuan and the rural residents' is 900.00 yuan. The residents' medicalexpenditure for one year is estimated 19.98 billion yuan. Age, individual annual income, the time to the nearest medical organization, self evaluation health status, the serious extent of self-feeling about the disease and the level of the health institute are the main factors of the urban residents' outpatient expenditure. And the main factors of the urban residents' inpatient expenditure include individual annual income, Engel coefficient, medicare, ill with chronic diseases, operation, the hospitalized days and the level of the health institute. In rural area, age, Engel coefficient, the time to the nearest medical organization, ill with chronic diseases, the serious extent of self-feeling about the disease and the level of the health institute are the main factors of the residents' outpatient expenditure. And the main factors of the rural residents' inpatient expenditure include age, Engel coefficient, operation, the hospitalized days and the level of the health institute.Conclusions The residents' medical expenditure for one year was very large in Sichuan province. In order to control the increasing medical expenditure, some effective stratigies should be carried out, such as improving prevention and health care, strengthening the prevention of chronic diseases, improving the mass health status, enhancing the community health services and making the three-level bidirectional transfer hospitalized system perfect.