PHÂN TÍCH CHI PHÍ TRỰC TIẾP Y TẾ TRONG ĐIỀU TRỊ ĐÁI THÁO ĐƯỜNG TÍP 2 CHO NGƯỜI BỆNH CÓ BẢO HIỂM Y TẾ TẠI BỆNH VIỆN ĐA KHOA KHU VỰC LONG THÀNH, TỈNH ĐỒNG NAI NĂM 2023

Abstract

Objective: This study aimed to analyze direct medical costs and associated factors in the treatment of type 2 diabetes mellitus (T2DM) at Long Thanh Regional General Hospital, Dong Nai in 2023, in the context of the growing urgency to manage chronic disease treatment costs at the primary healthcare level. Methods: A cross-sectional retrospective study was conducted using electronic medical records of T2DM patients (ICD-10: E11) treated as inpatients and outpatients between January 1 and December 31, 2023. Direct medical costs per visit were calculated, including consultation, hospital bed, medications, laboratory tests, imaging, procedures, and medical supplies. Data were processed using Excel and analyzed in SPSS version 20. A generalized linear model (GLM) was applied to analyze factors associated with treatment costs. Results: A total of 3,011 patients and 20,709 treatment episodes were analyzed, with 98.5% being outpatient visits. The mean cost per inpatient episode was 1,962,700±1,557,480 VND, with hospital bed charges being the largest component (48.2%). Outpatient visits cost an average of 495,663±282,184 VND, primarily from medications (80.5%). Among antidiabetic medications, insulin accounted for the highest proportion in both inpatient (81.4%) and outpatient settings (32.6%). Regression models identified older age and comorbidities as significant cost-increasing factors in inpatients. In outpatients, gender, age group, residence, comorbidity status, and insurance coverage level were statistically associated with total costs (p < 0.05). The average health insurance reimbursement covered 84.2% of inpatient and 87.1% of outpatient direct medical costs. Conclusion: Direct medical costs for T2DM treatment are substantial, particularly among elderly patients and those with comorbidities. The findings underscore the importance of managing comorbidities, optimizing treatment models, and rational resource use to ensure effective treatment, cost containment, and sustainability of the health insurance fund.