Total per-visit medical expenses incurred by outpatients with diabetes-Evidence from six provinces in eastern China

Abstract

Background: Chronic diseases associated with diabetes threaten the health of Chinese people and contribute to poverty.

Methods: Medical service utilization records of 78 124 visits by outpatients with diabetes to medical institutions in China's eastern region between 2013 and 2015 were randomly selected from the Medical Insurance Department (MID) database. One-way analysis of variance (ANOVA) was used to compare the average total per-visit, out-of-pocket (OOP), and medical insurance (MI) fund expenses between variables. Multiple linear regression analysis was performed to identify possible risk factors affecting total per-visit medical expenses.

Results: Average total per-visit medical expenses were 244.59, 285.56, and 435.33 yuan in primary, secondary, and tertiary medical institutions, respectively. Significant differences were found for average total per-visit medical expenses by year of visit, age, type of medical insurance, and levels of medical institutions. No significant differences were found for average total per-visit medical expenses by gender.

Conclusion: The functions of medical networks at all levels should be clarified and the Urban Resident Basic Medical Insurance (URBMI) reimbursement ratio improved to ensure equal access to medical services irrespective of medical insurance type. Patients with chronic diseases should be encouraged to visit primary medical institutions to reduce medical expenses.

Keywords: chronic disease; epidemiological transition; outpatients with diabetes; total per-visit medical expenses.