按人头支付政策干预对患者住院服务利用的影响分析

发布时间：2018-05-04 19:18

本文选题：新型农村合作医疗 + 支付方式改革　；参考：《中国卫生经济》2017年07期

【摘要】：目的:分析按人头支付政策干预对参合对象住院服务利用的影响。方法:收集2011—2015年浦东新区按人头支付干预前后新型农村合作医疗参合对象住院服务利用相关数据,通过比较分析,评价政策干预对参合对象住院服务利用的影响。结果:超过70%的住院医疗服务利用发生在二三级医疗机构,且政策干预后更加向二三级医疗机构集中;其中二级医疗机构2015年住院人次数占52.58%,住院费用占61%;从环比增速来看,二三级医疗机构次均住院费用增速分别从政策干预前的31.49%和8.58%下降到2015年的3.84%和4.05%。结论:参合对象的总体住院服务利用次数和费用均逐年增加,二级医疗机构住院费用增长趋势明显;政策干预后二三级医院参合对象次均住院费用的增长得到明显遏制。
[Abstract]:Objective: to analyze the effect of the policy intervention on the utilization of inpatient service. Methods: the data of hospitalization service utilization of participants in the new rural cooperative medical system before and after the intervention were collected from 2011 to 2015 in Pudong New area, and the effect of policy intervention on the utilization of hospitalization service was evaluated by comparative analysis. Results: more than 70% of the inpatient medical service utilization occurred in the second and third level medical institutions, and after the policy intervention, it was even more concentrated in the second and third level medical institutions, in which the number of in-patient visits in the second-level medical institutions accounted for 52.58 in 2015, and the hospitalization expenses accounted for 61.From the month-on-month growth rate, The average hospitalization cost growth rate of the second and third level medical institutions decreased from 31.49% and 8.58% before the policy intervention to 3.84% and 4.05% in 2015 respectively. Conclusion: the utilization times and expenses of total hospitalization services of the participants increased year by year, the increasing trend of hospitalization expenses of the secondary medical institutions was obvious, and the increase of the average hospitalization expenses of the participants in the second and third level hospitals was obviously restrained after the policy intervention.
【作者单位】：浦东新区卫生和计划生育委员会;浦东卫生发展研究院;浦东新区新型农村合作医疗管理办公室;
【基金】：国家自然科学基金项目(71503170) 上海市卫生和计划生育委员会科研课题(201440036,201540400) 上海市浦东新区卫生和计划生育委员会科技发展专项基金项目(PW2016A-4)
【分类号】：F323.89;F842.684;R197.1

【参考文献】