Analysis of Hospitalization Expenses of Patients With Acute Myocardial Infarction in Basic Medical Insurance of Urban Population / 中国循环杂志

ABSTRACT

Objectives: To analyze the rate of hospitalization for acute myocardial infarction (AMI) and the cost of hospitalization for urban residents participating in national basic medical insurance in China. Methods: Of the sample database of inpatients participating in the national basic medical insurance system from 2010 to 2014, 2%, 5% and 10% of the insured persons was selected from provincial cities, one prefecture-level city, and two county-level coordinating regions of each province, with a total of 2 523 265 person-times. Patients with AMI who were diagnosed with ICD-10 code I21-I22 from the hospital were selected for analysis. Results: A total of 1 347 patients were diagnosed with AMI in the sample database. It was estimated that the annual AMI hospitalization rate was 44.2 per 100 000 according to the hospitalized AMI patients from 2012 to 2014. The median hospitalization cost was 31 000 (42 000) RMB and the median length of stay was 9 (8) days. The per capita hospitalization cost of provincial insured personnel was the highest (40 000 RMB), followed by prefecture insured personnel (30 000 RMB), and the county insured personnel (15 000 RMB, P<0.001). The proportion of patients receiving percutaneous coronary intervention (PCI) in provincial and prefecture cities was significantly higher than that of county-level patients (50.1%, 43.2%, and 14.9%, respectively, P<0.001). The median hospitalization cost for PCI was 52 000 RMB, which was significantly higher than thrombolytic therapy (20 000 RMB) and conservative treatment (13 000 RMB, P<0.001). Conclusions: The cost of AMI hospitalization for patients with basic medical insurance in provincial cities, perfeture and county cities in China is significantly different, and it is related to the large difference in the proportion of patients receiving PCI or not.