Hospitalization Expense Of Peasant Workers Patients With Medical Insurance Of Tianjin And Its Influencing Factors

Objective The hospitalization cost and basic information of peasant workers patients with medical insurance in Tianjin from2009to2012were collected. Gray Correlation Analysis, Degree of Structure Variation Analysis and Multivariable linear regression method were used to clear the relationship among expenses components and hospitalization cost The results and the suggestions can be used as a guidance to control the rising cost and reference to improve the medical insurance policy.Methods A total of9150peasant workers patients with medical insurance in hospitals of Tianjin from2009to2011were recruited. The hospitalization cost details were divided into seven parts of the medicine cost, examination cost, treatment cost, surgery cost, material cost,bed cost and other cost. Various costs were described and sorted by different characteristics of patients. The method of Gray Correlation Analysis and Degree of Structure Variation Analysis was adopted to make the quantitative analysis of the hospitalization cost. Multivariable linear regression method was applied to analyze the influencing factors of hospitalization cost with SPSS18.0.Results The average hospitalization cost was11552.17yuan per patient with medical insurance in Tianjin from2009to2011. In the whole cost, the medicine cost, material cost, examination cost, treatment cost, surgery cost, bed cost and other cost account for37.82%,20.80%,17.54%,11.91%,7.67%,3.35%and0.91%. As indicated by the method of Gray Correlation Analysis, the medicine cost was the largest part followed by material cost and examination cost. Degree of Structure Variation Analysis showed DSV of hospitalization cost between2009and2012was15.52%, the mean DSV was5.17%. The expense on medicine, material and examination were major items which affect the structure variation, the cumulative contribution rate was75.51%. The cost of medicine, examination, treatment, bed, the other and total costs of male cases were more than female cases while the opposite result of surgery and material cost. The differences of the medicine cost, examination cost, treatment cost, surgery cost, bed cost, material cost and total costs were statistically significant (P<0.05) in various age range. The cost of medicine, examination, treatment, bed, material, the other and total costs of emergency hospitalization cases were more than not emergency hospitalization cases while the opposite result of surgery cost. The cost of treatment, surgery, material of ordinary disease cases were more than special disease cases while the opposite result of medicine cost, examination cost, bed cost, other cost and total costs. The cost of medicine, examination, treatment, surgery, bed, material, other cost and total costs were increasing by degrees accompanied the hospitals levels. The cost of treatment, surgery, bed, material, other costs and total costs of peasant workers patients who had operations were more than those who hadn’t. The cost of every expenditure items above except surgery cost was increasing accompanied length of stay. The results of multi-regression analysis showed that the major factors influencing the hospitalization expenses in peasant workers patients with medical insurance in descending order of length of stay, rank of hospital, operation or not, the age, emergency or not, the sex and payment of category.Conclusion Prospective effect was got by the application of Gray Correlation Analysis and Degree of Structure Variation Analysis. The expense on medicine, material and examination were major items which affect the structure variation. The controllable influencing factors of the hospitalization expenses in peasant workers patients were screened by the results of multi-regression analysis, and the controllable influencing factors can be used as a guidance to control the rising cost and reference to improve the medical insurance policy. The available measures should be taken to reduce the hospitalization expense:(1)Reducing length of stay;(2)To select the low class hospital;(3)Expanding the insurance coverage;(4) Strengthen health education.