ĐÁNH GIÁ TỶ LỆ CƠ CẤU CHI PHÍ THANH TOÁN BẢO HIỂM Y TẾ TẠI CÁC CƠ SỞ Y TẾ CÔNG LẬP TỈNH SÓC TRĂNG NĂM 2018 - 2019

Abstract

Background: The propotion of people participating in health insurance in Soc Trang is about 97,5%. It is necessary to determine the proportion of the payment structure for health insurance in public hospitals in Soc Trang province, makes it possible for hospitals to be more proactive in building financial plans, balancing revenues and expenditures to achieve the highest efficiency in using the health insurance fund. Objectives: To determine the proportion of the health insurance payment structure of public hospitals in Soc Trang province in 2018 - 2019. Materials and methods: A cross-sectional description of data on payment of medical costs Health insurance diseases in 8 public health facilities in Soc Trang province: Soc Trang General Hospital, Soc Trang Hospital for Women anh Children, Soc Trang People Military Hospital, My Tu Medical Center, Tran De Medical Center, Cu Lao Dung Medical Center, Vinh Chau Medical Center, Nga Nam Medical Center in 2018- 2019. Results: The total number of health insurance records in the research was 2,236,425 records of which, in 2018, the total cost of health insurance paid in both years is 1,032,741,677,256 VND, the average cost for the general treatment was 480,293 ± 2,429,285 VND in which payment by health insurance is 461,782 ± 2,327,160 VND. The proportion of payment structure that accounts for the most is drug costs 28.6%, hospital bed costs 24%, expenses for surgery, procedures 18.3%, testing 9.7%, diagnostic imaging 6.4%, medical examination 5.7%, medical supplies 5.4%, blood and products 1.6%, shipping 0.4%. Conclusions: Health insurance covers about 96.1% of total costs incurred during the treatment of insured patients at public hospitals in Soc Trang province the most is drug cost, the proportion of health insurance payment structure remains unchanged between 2018 and 2019.