基于时间序列的按人头支付对门诊医疗费用的影响分析

发布时间：2018-11-01 11:53

【摘要】：目的:分析按人头支付政策干预对参合对象门诊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门诊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门诊医疗费用的影响。结果:政策干预后40个月参合对象的实际次均门诊费用(90.37元)较干预前20个月(84.98元)增加了6.34%;Holt-winters加法模型结果显示,按人头支付政策干预后,次均门诊费用的模型预测值(102.00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门诊人次与预测值间差值无统计学差异(P0.05)。结论:按人头支付政策干预3年多来,对控制参合对象次均门诊费用效果显著,在控费的同时未抑制门诊需求的正常释放。
[Abstract]:Objective: to analyze the effect of policy intervention on outpatient medical expenses. Methods: the data of medical expenses of outpatients in New Rural Cooperative Medical system (NCMS) before and after the intervention were collected from 2011 to 2015 in Pudong New area, and the influence of policy intervention on outpatient medical expenses was evaluated by time series analysis. Results: the actual average outpatient expenses of the participants 40 months after the policy intervention (90.37 yuan) increased 6.34 yuan compared with 20 months before the intervention (84.98 yuan). The results of Holt-winters addition model showed that the predicted value (102.00 yuan) of the average outpatient expenses was significantly higher than the actual value (P0. 001) after the policy intervention. At the same time, the results of simple seasonal model showed that there was no statistical difference between the actual outpatient visits and the predicted values (P0.05). Conclusion: for more than 3 years, the policy of paying according to human head has a remarkable effect on controlling the average outpatient expenses of participants, and it does not restrain the normal release of outpatient demand while controlling the cost.
【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(PW2016A-4)
【分类号】：F323.89;F842.684;R197.1

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