ABSTRACT
@#Abstract： Objective To investigate and analyze the factors influencing the direct medical costs of tuberculosis patients in Hainan Province, so as to provide scientific reference for reducing the medical burden of patients and adjusting the medical insurance reimbursement policies in the local area. Methods Using the total health expenditure accounting data of Hainan Province in 2020, including the outpatient and inpatient data of 14 provincial medical institutions, 235 city and county level medical institutions, and other relevant data from the 2020 Hainan Statistical Yearbook and Health Financial Yearbook, the direct medical costs of tuberculosis patients in the province in that year were calculated, and the influencing factors were explored using single factor analysis and multivariate generalized linear model. Results The final number of cases included in this study was 11 979, including 7 526 males (62.83%) and 4 453 females (37.17%). The total direct medical costs of patients were 43.207 3 million yuan, of which the total outpatient costs were 2.733 9 million yuan (6.32%) and the total inpatient costs were 40.473 4 million yuan (93.67%). In the cost composition analysis, the drug cost was 17.971 million yuan (41.44%), the examination cost was 8.854 7 million yuan (20.49%), other costs were 16.445 5 million yuan (38.06%), and the median (quartile) M(P25,P75) direct medical cost of each patient was 177.50 (66.73,764.89) yuan. The multivariate generalized linear model analysis showed that hospitalization, new rural cooperative medical insurance (NRCMI) and urban employee medical insurance were the influencing factors of the increase in direct medical costs of tuberculosis patients the median (quartile) M(P25,P75) of direct medical costs are 10 425.04 (6 560.87,17 374.9), 10 246.5 (5 871.28,17 220.33), 3 177.2 (293.09,7 730.23) yuan respectively; the OR(95%CI) values were -3.505 (-3.499- -3.517), 1.559 (1.551-1.569) and 2.191 (2.188-2.207) respectively. Conclusions The direct medical costs of tuberculosis patients in Hainan Province are high. Hospitalization, the new rural cooperative medical insurance and the medical insurance for urban workers are the influencing factors of the increase in costs.