基于时间序列的按人头支付对住院医疗费用的影响分析

发布时间：2018-05-18 02:22

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医疗费用的相关影响。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住院患者医疗费用相关数据,通过时间序列分析方法,评价政策干预对参合对象住院医疗费用的影响。结果:政策干预后40个月参合对象的实际次均住院费用(11 176.95元)较干预前20个月(8 279.66元)增加了34.99%;按人头支付政策干预后,次均住院费用的模型预测值(12 836.63元)明显高于实际值(P0.001);同时,简单季节模型结果显示,同期参合对象的实际住院人次与预测值基本持平(P0.05)。结论:按人头支付政策干预实施3年多来,有效遏制了住院患者医疗费用的过快增长,但未抑制住院服务需求的合理释放。
[Abstract]:Objective: to analyze the influence of the policy intervention on the inpatient medical expenses. Methods: the data of medical expenses of the new rural cooperative medical care patients before and after the intervention were collected from 2011 to 2015 in Pudong New area, and the effects of policy intervention on the medical expenses of the participants were evaluated by time series analysis. Results: after 40 months of policy intervention, the actual average hospitalization cost of the participants was 11 176.95 yuan), which was 34.99 yuan higher than that of 20 months before the intervention. The predicted value of average hospitalization cost by the model was 12 836.63 yuan) significantly higher than that of the actual value (P 0.001), and the results of simple seasonal model showed that the actual hospitalization time of the participants in the same period was basically equal to the predicted value (P 0.05). Conclusion: for more than 3 years, the policy of paying according to human head has effectively restrained the excessive increase of medical expenses of inpatients, but it has not restrained the reasonable release of the demand for in-patient service.
【作者单位】：浦东卫生发展研究院;浦东新区卫生和计划生育委员会;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-1,PW2016A-4)
【分类号】：F323.89;F842.684;R197.1

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