Phân tích chi phí điều trị và các yếu tố ảnh hưởng ở người bệnh nội trú có bảo hiểm y tế tại Bệnh viện Trung ương Quân đội 108, giai đoạn 2019-2023

Abstract

Objective: To analyze the cost structure and key factors influencing the total inpatient treatment costs among patients covered by health insurance at the 108 Military Central Hospital during the period 2019–2023. Subject and method: A cross-sectional descriptive study was conducted using secondary data from 355,797 inpatient admissions with health insurance coverage between November 2018 and November 2023. Data were processed and analyzed using SPSS version 20. Result: The total inpatient treatment cost showed an upward trend, increasing from VND 1,049.83 billion in 2019 to VND 1,447.72 billion in 2023. The proportion of costs covered by health insurance slightly declined from 77.1% to 76.0%, while the patient co-payment portion increased from 7.5% to 9.1%. Significant changes were observed in the cost structure, with the proportion of drug costs decreasing from 24.0% to 23.1%, and that of medical consumables rising from 33.0% to 42.6%. Linear regression analysis identified total length of stay (β = 0.35), treatment outcomes (β = 0.09), and referral level (β = -0.09) as the primary factors influencing total treatment costs; age and gender had negligible effects. Conclusion: Inpatient treatment costs for insured patients at the 108 Military Central Hospital increased steadily from 2019 to 2023, accompanied by a rising share of medical consumables and patient co-payments. Strengthening the control of high-cost technologies and improving the efficiency of health insurance fund utilization are essential to reducing patients' financial burden and ensuring the sustainability of the health insurance system.