KHẢO SÁT CHI PHÍ KHÁM CHỮA BỆNH BẢO HIỂM Y TẾ TẠI BỆNH VIỆN ĐẠI HỌC TÂY NGUYÊN GIAI ĐOẠN 2017 – 2021

Abstract

Background: The increased cost of health insurance increases the burden on the health insurance fund in paying for medical examination and treatment costs. That leads to certain difficulties for medical facilities in managing and controlling payment sources in general and health insurance funds in particular. The objective of the study was to survey the cost of medical examination and treatment covered by health insurance at the Tay Nguyen University Hospital in the period 2017 - 2021. With a cross-sectional descriptive method based on retrospective data at Tay Nguyen University Hospital in the period 2017 – 2021 on the research sample included 455,328 outpatient medical records and 20,988 inpatient medical records recorded in the period 2017-2021. In which, the total cost of treatment was 144,323,488,418 VND with 82,28% paid by the health insurance fund and 12,72% paid by the patient. In the structure of the health insurance fund, expenses for drugs and surgical procedures dominate with 31.56% and 24.45%, respectively. Thus, in the period 2017 – 2021, at Tay Nguyen University, the cost of health insurance coverage accounts for the majority of the total treatment costs of patients with the costs of drugs and surgical procedures dominating. This is the basis for formulating policies on effective use of health insurance funds in treating hospitals and management agencies.