陈琛,宋沈超,杨媛,刘岚
CHEN Chen,SONG Shenchao,YANG Yuan,LIU Lan

• 1:贵州医科大学公共卫生学院
• 2:铜仁市人民政府

摘要(Abstract)：

目的:分析贵州省铜仁地区县域医共体组建后新农合患者流向发生的变化。方法:以2016-2018年铜仁地区已组建医共体的10个县区各级医疗机构为调查对象,对3年内县内和县外门诊就诊人次及报销费用、住院人次及报销费用进行分析。结果:从2016-2018年,县内门诊报销费用涨幅达到5.3%,县外门诊报销费用降幅达到2.71%;县内门诊人次涨幅为32.84%,县外门诊就诊人次降幅为46.76%;县内住院病人住院报销总费用增长了54 600.83万元、增幅为52.04%,县外住院报销总费用下降了12 021.72万元、下降比例为16.08%;县内住院人均报销增长4 815.11元,县外住院人均报销下降2 579.49元;县内住院人次增长14.33万人次、增幅为17.19%,县外住院人次下降了1.41万人次、降幅为3.16%。结论:铜仁地区县域医共体组建对减少新农合患者县外就医初见成效。
Objective: To analyze the impact of county medical alliance on patient flow under new rural cooperative medical system(NRCMS) in Tongren area of Guizhou Province. Methods: The medical institutions at 10 counties and districts which have NRCMS in the Tongren area from 2016 to 2018 were investigated. The numbers of outpatient visits, inpatients and their reimbursement expenses in the county and outside of the county were analyzed. Results: The reimbursement expenses of outpatients in the county increased by 5.3%, while the reimbursement expenses of outpatients outside of the county decreased by 2.71%. The number of outpatient visits in the county increased by 32.84%, while the numbers of outpatient visits outside the county decreased by 46.76%. The total cost of inpatient reimbursement in the county increased by 546.083 million yuan, an increase of 52.04%. The total cost of inpatient reimbursement outside the county decreased 1 202.172 million yuan, a decrease of 16.08%. The per capita reimbursement of per inpatient increased by 4 815.11 yuan in the county, while decreased by by 2 579.49 yuan outside the county. The numbers of inpatients increased by 143 300 in the county, an increase of 17.19%, while the number of inpatients decreased by 14 100 outside the county, a decrease of 3.16%. Conclusion: The establishment of county medical alliance in Tongren area has achieved initial success in reducing the number of NRCMS patients outside the county.

关键词(KeyWords)： 新医改;新农合基金;诊疗人数;病人流向;医疗机构
new medical reform;new rural cooperative fund;number of patients;patient flow;medical institutions

Abstract:

Keywords:

基金项目(Foundation): 贵州省科学技术基金[黔科合LG字(2012)020]

作者(Author): 陈琛,宋沈超,杨媛,刘岚
CHEN Chen,SONG Shenchao,YANG Yuan,LIU Lan

DOI: 10.19367/j.cnki.1000-2707.2019.09.006

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