NGHIÊN CỨU CHI PHÍ TRỰC TIẾP Y TẾ TRONG ĐIỀU TRỊ VIÊM PHỔI CHO NGƯỜI BỆNH NỘI TRÚ CÓ BẢO HIỂM Y TẾ TẠI BỆNH VIỆN PHỔI HẬU GIANG NĂM 2025

Abstract

Background: Pneumonia was a leading cause of morbidity and mortality globally, imposing not only health impacts but also a financial burden on patients. Objectives: To determine direct medical cost structure and investigate related factors in the treatment of pneumonia for inpatients with health insurance at Hau Giang Lung Hospital in 2025. Materials and methods: The study involved 148 medical records, invoices, and cost payment data for patients diagnosed with community-acquired pneumonia receiving inpatient treatment with health insurance at Hau Giang Lung Hospital from June 2025 to December 2025. The method used was descriptive cross-sectional analysis. Results: The average direct medical cost in treating pneumonia for inpatients with health insurance was VND 4,544,791.9 ± 2,318,889.9. Of this amount, insurance covered 89.6%, and the patient covered 10.4%. Regarding the structure, bed costs accounted for the highest proportion at 53.4%, drug costs at 26.8%, laboratory test costs at 11.1%, surgery and procedure costs at 4.5%, diagnostic imaging costs at 2.5% and medical supplies costs at 1.7%. A correlation was observed between direct medical costs and the number of treatment days (p<0.05). Conclusion: Direct medical costs in inpatient pneumonia treatment were primarily due to bed and drug costs, with the majority being covered by health insurance.