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[National Health Insurance expenditures in 1994 for thirty long-term illness]
P Fender1, M Païta, B Salanave
1Caisse Nationale de l'Assurance Maladie des Travilleurs Salariés (CNAMTS) Echelon National du Service Médical, Paris.
Objective:
The health insurance system carried out a survey in 1994 on the illnesses included in the regulations on the thirty long-term illnesses (ALD 30) exempt from patients' contributions to the costs of medical treatment. One of the objectives of this study was to provide the average amount, per patient with these illnesses, of the total expenditures of payments in kind reimbursed by the health insurance system and their distribution by principal expenditure post and by illness.
Methodology:
A sample of 67,828 patients was randomly selected at the rate of 2% of the total patients under ALD 30 in November 1994. The expenditures reimbursed over the course of June through November 1994 were collected from a computerized petition on the Health Insurance Information System.
Results:
The average annual cost per patient within the regulation is estimated at 35,991 FF (+/- 692). Close to half of these expenditures correspond to public hospital stays. The annual expenditures extrapolated from the total ALD 30 is estimated at 143.7 billion FF, or 35% of the total expenditures of payments in kid reimbursed by the health insurance system. "Mental illnesses" represent the largest portion of these expenditures given to ALD 30 (23%).
Conclusions:
The survey allows for an evaluation of the average cost per patient covered 100% by the health insurance system under ALD 30. For the majority of these illnesses, these evaluations are the only benchmarks currently available.