关键词: 结核,肺, 费用,医疗, 医疗保险, 筹资,建设, 评价研究

Abstract:

Objective To evaluate the effectiveness of the new financing mode (government funding after medical insurance, financial support from different sources) by comparing the medical expenses of pulmonary tuberculosis patients among the three districts (Xingqing, Jinfeng, and Xixia) in Yinchuan City in 2016 and 2019. Methods Derive a total of 823 cases of pulmonary tuberculosis patients registered in the three districts from the “Tuberculosis Management Information System”, screen all patients’ inpatient and outpatient expenses during the entire treatment period form the “Hospital Information System” of the Fourth People’s Hospital in Ningxia Hui Autonomous Region, 805 cases were retrieved, and to compare the changes of hospital expenses generated by patients in 2016 and 2019. Results A total of 805 cases of tuberculosis patients were enrolled in this study, including 459 patients in 2019 and 346 patients in 2016, the number of males was 437, while the number of females was 368, and a male-to-female ratio of 1.2∶1. The total cost of patients’ self-pay proportion in 2019 was 25.9% (13.1%, 37.1%), compared with 30.9% (6.8%, 39.6%) in 2016 (Z=-2.935, P=0.003). The proportion of outpatient expenses paid by patients was 28.6% (24.4%, 33.4%) in 2019, lower than 34.6% (30.1%, 40.0%) in 2016 (Z=-8.076, P<0.001). There was no statistical significance in the proportion of outpatient expenses paid by patients. In 2016, the cost of drugs accounted for the highest proportion of the total treatment cost of tuberculosis patients which was 42.8% (1890000 yuan/4416000 yuan), and this was reduced to 31.0% (2181000 yuan/7027000 yuan) in 2019. In 2016 and 2019, the outpatient examination cost accounted for 67.8% (259000 yuan/382000 yuan) and 67.2% (602000 yuan/896000 yuan) respectively, both accounted for the highest proportion of the outpatient cost in the same year. Among hospitalization expenses, the highest proportion in 2016 was drug expenses accounting for 44.8% (1806000 yuan/4034000 yuan) and this was reduced to 32.0% (1963000 yuan/6129000 yuan) in 2019. Conclusion After the implementation of the fund-raising mode for tuberculosis patients in Yinchuan, the financial burden of tuberculosis patients was reduced to a certain extent. We should continue to ensure the sustainability of the special subsidy funds, expand the scope of medical insurance, optimize the contents of the coverage, and implement the “one-stop” model.

Key words: Tuberculosis,pulmonary, Fees,medical, Medical insurance, Financing,construction, Evaluation studies