Implementation effect of singl disease based medical expense limitation in a county hospital in Hubei province

Objective To analyze implementation effect and problems of single disease based medical expense limitation(SDB-MEL) and to provide evidenses for the improvement of SDB-MEL.Methods Analysis of variance(ANOVA) and nonparametric tests were used to analyze the data on medical expenses for treatment of gallstone and cholecytitis in a county hospital of Dangyang city, Hubei province during 2010 through 2012 after the implementation of SDB-MEL.Results During the period, the sefl-paid medical expense quota decreased from 1 500 RMB yuan to 1 070 RMB yuan for operation treatment of gallstone and cholecytitis, and from 2 150 RMB yuan to 1 310 RMB yuan for laparoscopic surgery.The proportion of the patients under management of SDB-MEL increased from 75.00% to 82.03%, and that of the patients with laparoscopic surgery was 97.44% in 2012.The hospitalization days for the patients with laparoscopic surgery decreased from 9.21 to 8.24 while the compensation ratio increased from 50.55% to 61.30% and the amount of self-paid cost decreased from 2 199.55 RMB yuan to 1 777.62 RMB yuan, with significant differences(P<0.05).The ratio of the total cost higher than the quota of SDB-MEL decreased from 90.91% to 25.00% for total operation fee and from 74.56% to 32.24% for laparoscopic surgery.But the medical expense paid actually by the patients was higher than the quota.Conclusion The SDB-MEL should be implemented continuously but reasonable quota and needs to be estimated and superoision on SDB-MEL management needs to be promoted.