Chronic hepatitis B virus infectors' use of medical services and the expenses incurred / 中华医院管理杂志

ABSTRACT

Objective To assess the use of medical services by patients with chronic hepatitis B, cirrhosis resulting from hepatitis, or hepatic carcinoma and the composition of the expenses incurred. Methods A survey was made on the use of outpatient and inpatient services as well as the details of medical expenses incurred by 1 395 self-funded patients and patients enjoying social medical insurance in Shanghai. And an analysis was made on the composition of the expenses and direct medical expenses per annum. Results There was no significant difference between the self-funded group and the insurance group in the use of outpatient and inpatient services; in terms of medical expenses, those incurred by the insurance group were 30% to 50% higher than those incurred by the self-funded group; an analysis on the composition of outpatient expenses showed that drug expenses accounted for over 80% and examination and test expenses accounted for over 15%; an analysis on the composition of inpatient expenses showed that drug expenses incurred by the two groups both accounted for 45% to 60% of the total expenses and examination and test expenses accounted for 15% to 25%. Conclusion Social medical insurance reduces the economic burden of individual patients but significantly raises treatment expenses. The key to containing the rise of medical expenses lies in controlling the conversion of hepatitis B to cirrhosis and the irrational growth of inpatient drug expenses and examination and test expenses.