城镇医保对口腔医疗卫生服务费用影响因素的探讨

目的通过对城镇医保及非医保居民在口腔医疗卫生服务费用的定量研究,探讨其影响因素,为当前城镇医疗保险制度及口腔医疗费用支付提供科学依据。方法利用2008-2010年在湖南省人民医院口腔科就诊患者的连续性资料按照享有医保及非医保患者分为两类,采用单因素分析比较两者口腔医疗服务费用及多元回归分析法对口腔卫生服务费用影响因素进行分析。结果医保患者在次均口腔医疗费用及年总口腔医疗卫生服务费用均比非医保患者高;是否46-64岁、是否大于65岁、是否科技干部、是否商业服务、是否离退休、文化程度、收入、储蓄、是否拔牙、是否急性牙痛是医保及非医保患者的口腔医疗服务费用的影响因素,其中是否离退休、是否46~64岁、文化程度、是否急性牙痛、患者收入是医保患者口腔医疗卫生服务影响最显著的5个因素;而是否拔牙、是否急性牙痛、是否离退休、文化程度、患者收入是非医保患者口腔医疗卫生服务费用影响最显著的5个因素。结论医保患者的口腔医疗卫生服务费用要高于非医保患者,且费用主要影响因素也不同。本研究结果可为长沙市口腔医疗保障制度及口腔医疗卫生服务费用预测提供一定的参考依据。

Discussion on Influencing Factors of Expenditures for Dental Medical Services in Medicare and Non-medicare Patients

Objective To explore the influencing factors of dental medical services in medicare and non-medicare patients with quantitative research method,and to provide a scientific basis for revision of medicare and forecast of dental medical service expenses. Methods Using the continuous data？of patients who took dental treatment in the People＇s Hospital of Hunan Province from 2008 to 2010,and according to the variable of enjoying medicare or not,the data were divided into two groups.Univariate analysis was used to compare dental medical service expenses between the two groups,and multiple regression analysis was used to explore the influencing factors of two groups＇ dental medical service expenses. Results The total dental medical services per year and dental medical services per patient in medicare patients were higher than those in non-medicare patients.46～64 years old,more than 65 years old,scientific and technical personnel, business services,retirement,educational background,income,deposit,teeth extraction,and acute toothache were the influencing factors of dental medical services in both medicare patients and non-medicare patients.And retirement,46～64 years old,educational background,acute toothache,and patient＇s income were five main influencing factors in medicare patients,while teeth extraction,acute toothache,retirement,educational background,and patient＇s income were five main influencing factors in non-medicare patients. Conclusions The dental medical service expenses of medicare patients are higher than those of non-medicare patients,and the influencing factors of dental medical service expenses are different in both groups.The research will provide some references for revision of dental medical insurance system and forecast of dental medical service expenses.