按人头支付政策干预对患者门诊服务利用的影响分析

发布时间：2018-06-05 06:11

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门诊服务利用的相关影响。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参合对象门诊服务利用相关数据,通过比较分析,评价政策干预对参合对象门诊服务利用的影响。结果:80%的门诊服务利用发生在社区卫生服务机构,16%发生在二级医院;从费用来看,社区卫生服务机构和二三级医疗机构的门诊医疗费用各占一半;从环比增速来看,按人头支付政策干预后患者的次均门诊费用呈逐年下降的趋势,2015年二三级医疗机构参合对象次均门诊费用分别为275.46元和208.24元。结论:参合对象的总体门诊服务利用次数和费用均逐年增加,二三级医疗机构就诊增加明显;政策干预后对参合对象次均门诊费用控制较好,尤其二三级医院下降明显。
[Abstract]:Objective: to analyze the influence of the policy intervention on the utilization of outpatient service. Methods: the data about the utilization of outpatient service of the new rural cooperative medical system were collected before and after the intervention in Pudong New area from 2011 to 2015, and the effect of policy intervention on the utilization of out-patient service was evaluated by comparison and analysis. Results: 80% of the outpatient service utilization occurred in the community health service organization or 16% in the second class hospital. In terms of the cost, the outpatient medical expenses of the community health service organization and the second and third level medical institution were each half. The average outpatient expenses of the patients after the policy intervention were decreasing year by year. In 2015, the average outpatient expenses of the second and third level medical institutions were 275.46 yuan and 208.24 yuan respectively. Conclusion: the total outpatient service utilization times and expenses of the participants increased year by year, and that of the second and third level medical institutions increased obviously, and the average outpatient expenses of the participants were better controlled after the policy intervention, especially in the second and third level hospitals.
【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

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