The Analysis Of Maternity Insurance Hospitalization Expenditures And Its Affected Factors In A Tertiary Hospital

Objective:In order to provide a reference for administering efficiently maternity insurance,we analyzed the hospitalization costs of the individuals attending maternity insurance,and explored the factors influence hospitalization costs of delivery,and studied the effect of various factors on hospitalization costs.Methods:All individuals attending maternity insurance and having a delivery in a tertiary hospital in Taiyuan of the Shanxi Province from 2013 to 2016.Collect maternal discharge diagnosis,fertility,complications,the number of fetal,cost and other information from the HIS system of the hospital,after that.The reimbursement information related with above information were accessed as a supplement.The statistical description was done for age,job,mode of delivery,gestational age,gravidity,pathological pregnancy,multiple pregnancy,length of hospital stay,postpartum complications,hospitalization costs(Such as bed fee,nursing fee,treatment fee,inspection fee,surgical anesthesia,drug costs,material costs,and other fees).The relationship between the above factors and the cost of hospitalization was analyzed by univariate and/or multivariate analysis.Results:1.The constitute of hospitalization costs of delivery in the tertiary hospital.Hospitalization costs of delivery,in descending order,are drug costs,surgical anesthesia fee,material costs,treatment fee,inspection fee,bed fee,other fees and nursing fee,the top three of above costs are drug costs,surgery fees and material costs,accounted for 76.78% of the total cost.2.The main influencing factors of hospitalization costs of delivery.The results of univariate analysis showed that the average of hospitalization costs in the elder group was higher than in other age groups,and it is higher in the group of the cesarean section,the intervention group and the natural delivery group.The primiparous women’s hospitalization costs were higher than multipara women’s,multiple pregnancy group,postpartum complications and the longer hospitalization days made the higher hospitalization costs.The difference are not significant in the average hospitalization cost of individual’s job and gestational age.By multivariate analysis,the main factors for hospitalization costs are postpartum complications,mode of delivery,pathological pregnancy,the length of hospital stay and age.3.The flat rate payment of maternity insurance in the tertiary hospital.The average of the balance fee for natural childbirth was 162.61 Yuan and the balance ratio was 6.25%.The average of the balance fee for intervention delivery was 121.97 Yuan and the balance ratio was 4.69%.The average of the balance fee for cesarean was 136.32 Yuan and the balance ratio was 2.96%;and the cost for dystocia delivery was overtook significantly,the average was 507.28 Yuan,and the ratio was 17.89%.Conclusions:In descending order,hospitalization costs of delivery are drug costs,surgical anesthesia fee,material costs,treatment fee,inspection fee,bed fee,other fees and nursing fee.The main factors for hospitalization costs are postpartum complications,mode of delivery,pathological pregnancy,the length of hospital stay and age.The flat rate payment of maternity insurance had a few balance in the tertiary hospital.