背景:先天性小症提出了包括身体残疾和社会心理困扰的挑战。据悉,低收入人群生育先天畸形婴儿的可能性较高。2023年6月底,耳廓重建部分纳入我院国家医疗保险。
方法:简而言之,1290例手术,在2023年进行了Ⅰ期和Ⅱ期耳廓重建伴组织扩张术,涉及779例患者.患者数据,包括年龄,性别,逗留时间,residence,和成本,是从电子病历系统中检索出来的.医疗保险之前和之后的最终费用,并对各省市医保报销比例进行统计分析。
结果:在保险范围之后,观察到手术数量显着增加(514[39.84%]vs.776[60.16%],χ2=45.99,p=0.000),单边和双边第一阶段和第二阶段耳廓重建的自付费用显着降低(3915.01美元与$6645.28,p<0.05;$11546.80vs.5198.08美元,p<0.05)。各区域的偿还率存在明显差异,但与当地人均GDP没有相关性。住院时间与住院费用呈正相关。病人的年龄与住院费用无关,而是停留的时间。
结论:小耳畸形治疗的医疗保险显著减轻了患者家庭的经济负担,增加了耳廓重建手术的数量。这些发现强调了保险在提高先天性小耳病患者的医疗保健可及性和可负担性方面的关键作用。
BACKGROUND: Congenital microtia presents challenges that encompass physical disabilities and psychosocial distress. It is reported that people with low income have a higher possibility of giving birth to babies with congenital malformations. At the end of June 2023, auricular reconstruction was partially incorporated into national health insurance in our hospital.
METHODS: Briefly, 1290 surgeries, including stage-I and stage-II auricular reconstruction with tissue expansion were performed in 2023, involving 779 patients. Patient data, including age, sex, length of stay, residence, and costs, were retrieved from the electronic medical record system. The final cost before and after health insurance coverage, as well as the medical insurance reimbursement ratio in each province and municipality were statistically analyzed.
RESULTS: Following insurance coverage, a significant increase in the number of surgeries was observed (514 [39.84%] vs. 776 [60.16%], χ2 = 45.99, p = 0.000), with notable reductions in out-of-pocket costs for unilateral and bilateral stage-I and -II auricular reconstructions ($3915.01 vs. $6645.28, p < 0.05; $11546.80 vs. $5198.08, p < 0.05). Disparities in reimbursement rates across regions were evident, but showed no correlation to the local GDP per capita. There was a positive correlation between the length of stay and inpatient cost. Patient\'s age was not related to the inpatient cost, but to the length of stay.
CONCLUSIONS: The health insurance coverage for microtia treatment significantly alleviated financial burdens on the patients\' family and increased the number of auricular reconstruction surgeries. These findings underscore the critical role of insurance coverage in enhancing healthcare accessibility and affordability for patients with congenital microtia.