The Impact of the Upgrading of the Industrial Structure on the Urban Employee Basic Medical Insurance Fund: An Empirical Study in China

In-patient expenditure between 2011 and 2021 for patients with type 2 diabetes mellitus: a hospital-based multicenter retrospective study in southwest China

Background

Type 2 diabetes mellitus (T2DM) is a chronic non-infectious disease that seriously endangers human health. This study aimed to determine the main factors influencing the medical expenditure of T2DM patients and provide guidance for the allocation and control of medical expenditure.

Methods

The homepage data of patients with T2DM were retrospectively collected from six tertiary hospitals in southwest China from January 2011 to December 2021. A multiple linear regression model was constructed to examine the factors associated with medical expenses per patient. Furthermore, the trends of medical expenditure according to other important measures and patient subgroups were described, and a proportional breakdown of medical expenditure was generated. All expenditure data were reported in Chinese Yuan (CNY), based on the 2021 value, and adjusted using the year-specific healthcare consumer price index.

Results

A total of 45,237 patients with T2DM were analyzed in this study. Multiple linear regression showed that age, marital status, insurance type, length of stay, number of clinical visits, number of comorbidities, history of disease, history of surgery, smoking history, and the age-adjusted Charlson comorbidity index score were influencing factors of medical expenditure in patients with T2DM. Considering the overall average medical expenditure, diagnosis cost accounted for the largest proportion and was never <25% since 2011, showing a decreasing trend year by year. Among the types of comorbidity, hypertension was the most prevalent, followed by kidney disease and hyperlipidemia. In terms of the combination of comorbidities, medical expenditure was the highest for pulmonary infection+hypertension (24,360 CNY), followed by coronary heart disease+heart failure+hypertension (22,029 CNY).

Conclusions

Identifying the main factors influencing the medical expenditure of patients with T2DM can provide a reference for the medical security department to formulate reasonable compensation plans and for medical institutions to optimize treatment plans. Ultimately, this might reduce the financial burden of patients and relieve the pressure of medical insurance funds.

Analysis of hospitalization expenditures and influencing factors for inpatients with chronic bronchitis based on SHA2011 in a central Province of China

This study compared the hospitalization expenses of patients with chronic bronchitis in a central province (Province A) in China to estimate the direct medical cost of the family. Our data included hospitalization records of 30,341 patients with chronic bronchitis from five urban general hospitals in Province A. Using descriptive statistics and regression analysis, we explored the relevant factors affecting hospitalization expenses. Our study results have indicated that from 2016 to 2020, the medical expenditure of patients with chronic bronchitis increased annually, with an average annual growth rate of 22.65%. Among all kinds of expenses, the hospitalization expenses, drug cost, bed cost, test cost and other cost of UEMI (Urban Employee Medical Insurance) are higher than that of other types of medical insurance. The check-up fees of CMI (Commercial Insurance) are lower than that of other types of insurance. Between 2016 and 2019, the average medical expenses per patient with chronic bronchitis increased by 44%, which is the highest average medical expenses among patients aged 60-70. And the highest average medical expenditure emerged when the number of service days is between 5 and 10 days. The increase in expenditure could be attributed to the rapid development of medical technology and the increasing medical demand of the people. Overall, the results of our study implied a significant increase in medical expenses for patients with chronic bronchitis from 2015 to 2020, indicating that chronic bronchitis could bring heavy economic pressures to patients, their families and society.

Research on the Operational Efficiency of Basic Medical Insurance for Urban Employees in China-Based on Three-Stage DEA Model

Purpose

To conduct a three-stage data envelopment analysis (DEA) of the operational efficiency of urban employee basic medical insurance (UEBMI) across 31 provinces in China from 2012 to 2021.

Methods

Utilized a three-stage DEA model, this study measured and evaluated the operational efficiency of urban employee basic medical insurance within China's 31 provinces.

Results

The operational efficiency of urban employee basic medical insurance in China was notably low, displaying significant disparities across different regions and periods. Substantial room for improvement exists. Environmental factors, including urbanization level and unemployment rate, wielded a pronounced influence on the operational efficiency of China's employee medical insurance. Conversely, the fiscal revenue and expenditure ratio hindered the enhancement of employee medical insurance efficiency.

Conclusion

This study held valuable insights for enhancing the operational efficiency of China's urban employee basic medical insurance. To effectively improve insurance efficiency, the following recommendations are put forth: firstly, relevant departments should escalate resource investments and optimize resource utilization based on rational allocation; secondly, enhance legislation and regulations, fortify fund oversight, and ensure equitable and judicious utilization of the medical insurance fund; finally, leveraging modern high-tech advancements can comprehensively elevate the operational efficiency of the employee medical insurance fund. Ultimately, with the advent of cutting-edge technology, the operational efficiency of employee medical insurance fund can be comprehensively elevated.

In-patient Expenditure Between 2012 and 2020 Concerning Patients With Liver Cirrhosis in Chongqing: A Hospital-Based Multicenter Retrospective Study

Background

Liver cirrhosis is a major global health and economic challenge, placing a heavy economic burden on patients, families, and society. This study aimed to investigate medical expenditure trends in patients with liver cirrhosis and assess the drivers for such medical expenditure among patients with liver cirrhosis.

Methods

Medical expenditure data concerning patients with liver cirrhosis was collected in six tertiary hospitals in Chongqing, China, from 2012 to 2020. Trends in medical expenses over time and trends according to subgroups were described, and medical expenditure compositions were analyzed. A multiple linear regression model was constructed to evaluate the factors influencing medical expenditure. All expenditure data were reported in Chinese Yuan (CNY), based on the 2020 value, and adjusted using the year-specific health care consumer price index for Chongqing.

Results

Medical expenditure for 7,095 patients was assessed. The average medical expenditure per patient was 16,177 CNY. An upward trend in medical expenditure was observed in almost all patient subgroups. Drug expenses were the largest contributor to medical expenditure in 2020. A multiple linear regression model showed that insurance type, sex, age at diagnosis, marital status, length of stay, smoking status, drinking status, number of complications, autoimmune liver disease, and the age-adjusted Charlson comorbidity index score were significantly related to medical expenditure.

Conclusion

Conservative estimates suggest that the medical expenditure of patients with liver cirrhosis increased significantly from 2012 to 2020. Therefore, it is necessary to formulate targeted measures to reduce the personal burden on patients with liver cirrhosis.