Influencing factors of hospitalization cost among stroke inpatients with medical insurance

Objective To study components and main influencing factors of hospitalization cost among stroke inpatients with medical insurance,and to provide evidences for reasonable control of hospitalization cost and improvement of medical insurance system.Methods Medical records of 12 363 stoke patients with medical insurance hospitalized in a tertiary hospital in Anhui province from 2005 through 2014 were collected retrospectively.The components and main influencing factors of hospitalization cost among the inpatients were analyzed with univariate factor analysis and multivariate linear regression analysis.Results The median of hospitalization cost for the inpatients during the period was 7 746.74 (RMB Yuan),with an annually increasing tendency (P<0.01); the items of the hospitalization cost included medication (median=4 736.82,median of percentage=63.33%),materials (90.83,12.20%),examination (590.00,7.28%),treatment (433.00,5.82%),laboratory test (453.80,5.72%),bedding (216.00,2.94%),and nursing care (132.00,1.92%).The average length of hospital stay was 14.24 days with a median of 12.0 days.Multiple linear regression analysis indicated that the length of hospital stay was the strongest factor affecting medical cost and the hospitalization cost was positively correlated with the length of hospital stay,proportion of drug expense,ranking score at the admission,age of the inpatient,and with operation treatment and inversely correlated with curative effect among the inpatients.Conclusion Shortening the length of hospital stay and decreasing drug fee reasonably may be effective measures to lower the unreasonably growing in hospitalization cost for stoke inpatients with medical insurance.