Analysis on direct medical expenditure and its constituent of brucellosis patients in Shanxi

Objective To understand the medical cost burden of brucellosis patients in Shanxi province and provide evidence for the development of brucellosis prevention and control strategies and the optimization of health resource allocation. Methods The direct medical expenditure information of brucellosis patients were collected retrospectively from 5 medical institutions in 2 areas with serve brucellosis epidemic in Shanxi in 2015,and a database was established for the data analysis. Results Among 842 patients surveyed,the median of direct medical expenditure was 3 276.12 yuan(RMB),and it was 216.98 yuan(RMB)in 344 outpatients and 5 678.06 yuan(RMB)in 498 inpatients. The medical expenditure was significantly different among the patients. The median of medical expenditure of patients of city-level medical institutions was higher than that of patients of county-level medical institutions. Further analysis in 466 inpatients indicated that the medical expenditure mainly consisted of drug fee and laboratory test fee(70.45%),Seven patients who underwent surgeries had higher medical expenditure compared with the patients who underwent no surgeries(Z=-2.948,P=0.003),and their medical expenditure mainly included drug fee(40.62%),medical material fee(29.19%)and laboratory test fee(9.43%),while the medical expenditure of the patients without surgeries was mainly composed of drug fee and laboratory test fee(71.32%). There was no difference in medical expenditure between acute patients and chronic patients(Z=-1.249,P=0.212). Conclusion The economic burden of brucellosis patients was heavy. It is suggested to conduct standardized medical service according to the guideline of brucellosis diagnosis and treatment (2012 version) and strengthen the health education in population at risk,such as farmers and herdsmen,about self-protection,the importance of early medical seeking and how to reduce complications to lighten the economic burden for both society and individuals.