A Study On Determinants Of Hospitalization Expenditure Among Patients With Three Chronic Disease In The Primary Hospital In Hunan

Objective:To know the basic situation of the hospitalization expenditure for the patients with three chronic disease in the primary hospital of the Changsha and Chenzhou city in Hunan province, and to analyze the determinants of hospitalization expenditure.Methods:A cross-sectional survey was conducted to investigate the patients with three chronic disease in the grass-roots medical institutions in Changsha and Chenzhou City of Hunan province. Dataset was developed by the EPIDATA3.02 package, and the SPSS17.0 package was performed to process and analyze the data; Mean,median and frequencies were used to describe the data distribution, and rank sum test and analysis of variance were used for univairate analysis of hospitalization expenditure. The multiple liner regression models were performed to estimate the determinants of hospitalization expenditure.Results:A total of 342 patients with chronic diseases, including 116 hypertensive patients,109 coronary heart disease and 117 type 2 diabetes, had been recruited and surveyed. The result showed that 51.8% patients was female, and people with primary education were the largest proportion (31.3%), urban basic medical insurance system and new rural cooperative medical system had covered the majority of hospitaliztion expenditure(acounted for more than 70%), the majority of patients were farmer and married. The average age of patients was 64.3 years, the average length of stay in hospital was 12.2 days, the median of the total hospitalization cost was 3286 yuan and the mean was 4681 yuan, including the mean for 287 yuan of the checking cost,503 yuan of the laboratory cost,1917 yuan of the medicine costs; The median of the total hospitalization expenditure per time for hypertension, coronary heart disease and type 2 diabetes were 2858 yuan,3550 yuan和3475 yuan,respectively, and drug cost was the largest compoents of total hospitalization with the proportion of 40.96%. The length of hospital stay, medical insurance system and age were associated with the total hospitaliztion expenditure.Conclusions:The mean of the total hospitalization cost for patient with chronic diseases was 4681 yuan,and heigher than that of national county level hospital in 2009. The average cost of hospitalization for patient with hypertension was heightest, and drug cost was the largest compoents of total hospitalization with the proportion of 40.96%; The length of hospital stay, medical insurance system and age were associated with the total hospitaliztion expenditure.To shorten the length of stay and to prevent over medical demand in pospital were the key to control hospitalization expenditure of the chronic diseases.