目的分析职工医保与居民医保老年人的住院费用及报销水平,为完善医保相关政策提供参考。方法选取2013年浙江省某三甲医院住院老年人为研究对象,对享有职工医保与居民医保对象的住院及医保报销费用进行描述性分析。结果两类医保对象的住院疾病种类前6位的疾病均为慢性病,职工医保老年人占全年住院人次的39.14%,居民医保老年人占40.61%,职工医保老年人次均住院费用10 783元,药费占43.88%;居民医保老年人次均住院费用11 078元,药费占43.95%。两类医保对象相比,居民医保老年人住院费用高,报销比率低,药费是两类医保对象住院费用的主要构成部分。结论老年人住院费用较高,医院应加强药品费用等监控;同时政府部门应适当提高居民医保的报销水平,减轻居民医保老年人的经济负担。 Objective To analyze the hospitalization expenses and reimbursement level of medical insurance for the employees and residents and the elderly, and provide reference for improving the policy of health insurance. Methods The elderly inpatients in a top three hospital in Zhejiang Province in 2013 were selected as the research object, and the hospitalization expenses and health care reimbursement expenses for the workers covered by health insurance and residents were descriptively analyzed. Results The top 6 diseases of the two types of medical insurance were all chronic diseases. The elderly for medical insurance accounted for 39.14% of the total number of hospitalized residents, 40.61% of residents for medical insurance and the average cost of hospitalization for elderly workers was 10783 yuan, Medicines accounted for 43.88%; resident medical insurance for the elderly were 11,078 yuan per capita hospital expenses, accounting for 43.95%. Compared with the two types of medical insurance objects, the resident medical insurance senior citizens have high hospitalization expenses and low reimbursement rates, and the medical expenses are the main components of the hospitalization expenses of the two types of medical insurance objects. Conclusion Elderly hospitalization costs higher, the hospital should strengthen the monitoring of drug costs; the same time, government departments should be appropriate to increase the level of reimbursement of residents Medicare to reduce the economic burden on residents Medicare elderly.