靳帅,张侨,宋沈超
JIN Shuai,ZHANG Qiao,SONG Shenchao

• 1:贵州医科大学
• 2:贵州医科大学公共卫生学院预防医学教研室

摘要(Abstract)：

目的:分析贵州省县级及以上医疗机构新农合住院病人流向、住院费用及自付费用的变化情况。方法:以2012-2014年贵州省7个县县级及以上医疗机构新农合住院病案资料为研究对象,运用非参数检验及描述性统计分析病人流向、报销费用、住院费用及病人自付费用,以得到住院病人县内外医疗机构就诊流向及费用的变化趋势,分析造成这种变化的原因。结果:县外医疗机构住院人次明显上升,县级及以上医疗机构报销额年均占比呈上升趋势,县外医疗机构住院费用四分位数远高于县内医疗机构,县内外医疗机构病人自付费用变化差异有统计学意义(P<0.05)。结论:县外医疗机构住院人次、住院费用均明显高于县内医疗机构。
Objective:To analyze the changes of inpatients flow and new rural cooperative medical fund,hospital expense and self-paid expense.Methods:The subjects were selected from seven town medical care organizations from 2012 to 2014.Non-parametric test and descriptive statistics analysis were used to analyze the patients' flow,reimbursement,hospitalization and patient's paid expenses.In this way,the flows of hospitalization patients in and out of town medical care organizations and changes of expense were obtained and analyze the cause of the change.Results:Number of hospitalized people in out of town medical care organizations obviously increased; average annual reimbursement of medical institutions at county level and above is on the rise; quartile of out of town medical care organizations hospitalization cost was far above the in-town ones; difference of change of patients ' expense both in and out of town has statistical significance(P < 0.05).Conclusion:Number of hospitalized people and hospitalization expense in out of town medical care organizations are obviously higher than in-town ones.

关键词(KeyWords)： 新农合基金;住院费用;病人流向;报销;贵州
new rural cooperative fund;hospitalization costs;patient flow;reimbursement;Guizhou

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 靳帅,张侨,宋沈超
JIN Shuai,ZHANG Qiao,SONG Shenchao

DOI: 10.19367/j.cnki.1000-2707.2017.02.013

参考文献(References)：

• [1]中华人民共和国卫生部.中国卫生统计年鉴2008[M].北京:中国协和医科大学出版社,2008:53-54.
• [2]贵州省统计局.贵州统计年鉴2012[M].北京:中国统计出版社,2012:96-98.
• [3]郭梦童,吴群红,李叶,等.新农合下农村居民住院流向及费用负担变化趋势分析[J].中国医院管理,2015(1):72-74.
• [4]何平,刘博,孙强,等.安徽省基本药物改革前后新农合住院病人流向与医疗费用比较[J].中国卫生政策研究,2011(11):19-24.
• [5]金怡辰,宋沈超.医改前后贵州省各级医疗机构诊疗人次与入院人数变化分析[J].贵阳医学院学报,2014(2):176-179.
• [6]顾漪,徐伟平.提升县级公立医院服务能力的探索和实践[J].中国医院,2015(1):52-53.
• [7]贾继荣,高广颖,梁民琳,等.黑龙江省新农合分级诊疗制度实施情况及对策研究[J].中国医院管理,2016(1):5-7.
• [8]董有方,许丹.新农合定点医院的医药费用监管[J].中国卫生信息管理杂志,2010(3):59-64.
• [9]刘晓黎,刘华林,李睿.按项目付费体系下对我国医疗服务价格问题的思考[J].中国医药导报,2013(11):157-159.
• [10]贺锋,简伟研,邓小虹.2012-2014年北京市新型农村合作医疗住院疾病构成及费用研究[J].中国卫生经济,2015(12):530-532.
• [11]张静,韩菊,张晶.DRGs-PPS模式与项目付费模式的比较分析[J].中国卫生经济,2014(2):63-65.
• [12]孙雪玲,朱小余.医疗保险费用支付方式的选择分析[J].现代预防医学,2012(23):6185-6186.

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