中文摘要：

目的对医保与非医保患者住院医疗费用进行比较。为相关部门制定合理有效的费用监督和控制措施提供依据。方法以石家庄市5所医疗机构5种疾病、1211名住院患者为研究对象。运用秩和检验、卡方检验和多元线性回归分析方法。探索医保与非医保患者的费用分布及影响因素。结果医保患者比非医保患者花费了更多的医疗费，具有更高的药技比，但治疗效果并不比后者好；除住院天数、病种和是否手术三个共同影响因素外．医保和非医保患者住院费用还分别受其他不同因素影响。建议医疗保险制度未能发挥控制医疗费用上涨的作用．反而在一定程度上刺激了医疗消费，相关部门应综合考虑影响住院费用的诸多主要因素来控制费用的过快增长。

英文摘要：

Objective：Compare the hospitalized medical expense of the patients with？medical insurance to those without medical insurance, and provide some evidences for some valid and effective steps that would be taken. Methods： Based on the hospitalization costs survey of 1211 patients involved 5 diseases from 5 hospitals in ShiJiazhuang city, the paper explored the distribution and affecting factors of medical expense through Kruskal Wallis H, chi-square test, multiple linear regression. Results： The patients with medical insurance spent more medical expense than their counterparts, have higher ratio of medicine and technique, however, their curative effect was not better than latter. With the exception of hospitalization days, diseases sorts and OPS or not, others factors have unlike affects on the patients with medical insurance or without respectively. Conclusion： The system of medical insurance stimulated the medical consuming instead of controlling the rise of medical expense. Some comprehensive factors that affecting the rise of hospitalization expense？should be taken into. consideration when they establish relative steps.