PHÂN TÍCH CHI PHÍ TRỰC TIẾP Y TẾ TRONG ĐIỀU TRỊ CHO NGƯỜI BỆNH CÓ BẢO HIỂM Y TẾ TẠI BỆNH VIỆN LÊ VĂN THỊNH NĂM 2023

Abstract

Objective: This study aimed to analyze the direct medical costs incurred for patients with health insurance at Le Van Thinh Hospital (LVTH) in 2023. Methods: A cross-sectional descriptive study was conducted using a retrospective data collection approach to gather information regarding treatment costs for patients with health insurance at LVTH during the period from January to June 2023. Relevant data relating treatment characteristics (inpatient/outpatient; ICD-10 codes) and components of direct medical costs per treatment episode were collected and analyzed. Results: Within the period of January to June 2023, the total direct medical costs for patients with health insurance in the study sample amounted to 204.1 billion VND. Outpatient treatment costs accounted for 71.4% of the total expenditure. Three disease categories constituted more than 10% of the treatment costs, including cardiovascular diseases (25%), respiratory diseases (12%), and endocrine, nutritional, and metabolic diseases (12%). Pharmaceuticals represented 71.9% of the costs in outpatient treatment and 34.8% in inpatient treatment. The three major disease categories with substantial costs all had drug expenses exceeding 60%. Conclusion: The results provide essential information to support budget evaluation and adjustments for the procurement and utilization of healthcare services. The findings also serve as the foundation for designing and refining training plans for specialized personnel to better align with the current treatment requirements at the hospital.