Analysis of the Current Status of Consumable Medical Supplies Usage, Cost Structure, and Health Insurance Reimbursement Rates in Surgery at Phenikaa University Hospital in 2025

Abstract

A retrospective cross-sectional descriptive study was conducted at Phenikaa University Hospital in 2025 to analyze the utilization status, cost structure, and the affordability of Health Insurance (HI) for medical consumables and artificial implants. Results: The cost of medical supplies accounted for 26.53% of the total value of hospital inventory (exceeding 43.8 billion VNĐ). Within this, the budget was primarily concentrated on specialized medical supplies (38.90%) and replacement/ implant materials (15.03%). Notably, high-value items accounted for 79.93% of the total expenditure despite making up only a small proportion of the total number of items. Compared to common medical supplies, which are 100% covered by Health Insurance, high-tech implants frequently exceeded reimbursement caps. This led to significant variation in patient co-payments, ranging from 1.47 million to over 30.2 million VNĐ per case, depending on the specific type of material selected. Conclusion: The cost structure of medical supplies at the hospital shows strong differentiation, heavily concentrated in high-tech categories. These results highlight the urgent need to apply pharmacoeconomic/ health economic analysis to optimize material selection. Such measures are essential to ensure the balance of the Health Insurance fund and reduce the financial burden on surgical patients.