Comparison The Medical Insurance Cost Between Urban And Rural Residents And Analysis Of Its Influencing Factors

Objectives since2003, Hebei Province had established new rural cooperative medicalcare for rural residents and urban residents basic medical insurance for urban non-employed residents. Because of two aspects of health insurance policy managementprogram, the insured population, security benefits, etc., the hospitalization costs of urbanand rural residents have gaps. In this paper, the hospitalized medical cost between townand rural insured residents was compared, the influencing factors was explored. Tounderstand the factors affecting the composition and hospital costs and explore the maincause of rising medical costs of hospitalization, then put forward to control the growth ofmedical costs measures, in order to provide a reference for medical security system.Methods Information from the medical insurance center and new rural cooperativemedical care(NCMS)management system in one County, Hebei Province. The hospitalizedinsured cases joining medical insurance for urban and rural residents were selected in thecounty from January1,2011to December31,2011, the related personal data and thepatient’s hospital costs information were collected, and comparing the two systems underdifferences in hospital costs for medicare patients; Influencing factors of hospitalized costwere analyzed with univariate analysis and multivariate regression analysis, Usingstatistical software SPSS19.0. Statistical methods were Mann-Whitney U test, Kruskal-Willas H test and multiple analysis.Results1In the constitutes of the hospitalized medical cost for the two kinds ofmedicare patients, the front three were drug cost, treatment cost and inspection cost in turn.Urban medicare patients were53.76%,13.29%and9.91%; NCMS patients accounted for aproportion of52.95%,15.86%and12.05%.2On the hospitalization expenses payment,resident individuals to pay the proportion of Urban Medicare patients12.54%, and87.46%was the pooling fund; NCMS individual patient payment ratio and overall proportion offunds were paid33.60%and66.40%.3The results between urban medicare patientshospitalized residents and the NCMS patients cost comparison: The average hospitalizedmedical cost for urban residents (2069.77Yuan) was significantly higher than the ruralresidents (1936.11Yuan); The drug cost, inspection fees,surgical fees and specialinspection fees of urban patients were higher than rural patients (P＜0.05).4Factors ofurban residents hospital costs were age, hospital days, with or without surgery and hospital level. The hospital costs were increased with the age and the longer hospital days; surgeryand major inspection increased hospitalization costs of patients; the hospital costs ofcounty hospital were higher than the township hospital.5Factors of NCMS patientshospital costs were gender, age, hospital days, major inspection, with or without surgeryand hospital level. Cost of hospitalization in patients with male than female patients;patients hospital costs were increased under the extension of the hospitalization days;among different age groups, the hospital cost of patients were statistically significant (P＜0.05); hospital costs of surgical patients were more than non-surgical patients; the hospitalcosts of county hospital were higher than the township hospital(P＜0.05).Conclusions1Under the different medical security system, the hospitalization medicalcost of urban residents were higher than the NCMS residents.2The pooling fundscompensation levels of NCMS was lower than the medical insurance for urbanresidents, so it needed to be further improved.3According to the condition of patients tochoose hospital, under the premise of a clear diagnosis, drug therapy was chose reasonably,and the surgical indications were commanded strictly to reduce the days of hospitalization,so as to reduce the hospitalized cost and relieve personal and fund payment pressure.