Effects of medical insurance system and nursing care on the hospitalization cost effectiveness of acute myocardial infarction patients

Abstract Background Acute myocardial infarction is still a burden on Chinese patients. Whether different medical insurance system have any influence on the hospitalization cost and therapeutic effect of acute myocardial infarction patient needs further investigation. Methods In this study, 600 patients were stratified by health insurance status to investigate the cost effectiveness. Results Compared with free medical care, patients with other health insurance status have a significantly lower age (P ˂ 0.05~0.001), the youngest of which is new rural cooperative medical system. The hospital expense, nursing fee, length of stay, daily hospitalization cost, daily drug cost, daily nursing cost and percent of nursing cost of different health insurance status were statistically significant. ANCOVA analyses controlling for age showed that the differences of hospital expenses, nursing fee, length of stay and daily hospitalization cost were still statistically significant. Further studies found that health insurance status was the leading factors influencing length of stay (β =-0.305, P=0.0000001), nursing costs (β =-0.319, P=0.004), daily hospitalization costs (β =0.296, P=0.0001) and occurrence of clinical events (β =-0.186, OR=0.830, 95%CI 0.694-0.993, P=0.041). Conclusions The hospitalization cost, length of stay, nursing work and therapeutic effect of acute myocardial infarction patients are affected by different health insurance status and age.