基于结构变动度的新型农村合作医疗住院病人费用流向分析及政策探讨

发布时间：2018-03-23 09:30

本文选题：新型农村合作医疗　切入点：住院费用　出处：《中国卫生经济》2016年07期 　论文类型：期刊论文

【摘要】：目的:分析潍坊市2009—2013年度新型农村合作医疗住院病人住院费用结构变化情况,把握新型农村合作医疗住院病人费用流向和基金流向,为构建合理诊疗秩序、控制参保人群医疗总费用过快增长以及提高新型农村合作医疗基金使用效益提供依据。方法:采用结构变动度、结构变动值和结构变动贡献率等指标,从住院总费用及其分项目两个层面进行统计分析。结果:2009—2013年,一级医疗机构住院费用占比呈逐年下降趋势,二、三级医疗机构住院费用占比呈总体上升趋势。住院总费用结构变动度为21.46%,分项目结构变动度为40.48%。二级医疗机构各项目结构变动贡献率最高,累计达59.73%。一级医疗机构各项目呈负向变动,二级医疗机构个人自负呈负向变动,其余项目呈正向变动。结论:新型农村合作医疗住院病人有向更高级别医院流动的趋势,新型农村合作医疗筹资水平提高与医疗总费用大幅度上涨并存,建议通过医改政策合力来促进分级诊疗,限制医疗费用的过度上涨。
[Abstract]:Objective: to analyze the changes of the inpatient cost structure of the new rural cooperative medical system in Weifang city in 2009-2013, and to grasp the direction of the new rural cooperative medical care inpatients' expense and the fund flow, so as to establish a reasonable order of diagnosis and treatment. To control the excessive growth of the total medical cost of the insured population and to improve the efficiency of the new rural cooperative medical fund. Methods: using the index of structural change degree, structural change value and contribution rate of structural change, etc. From the two levels of total hospitalization cost and its sub-items, the results showed that the proportion of hospitalization expenses in first-level medical institutions decreased year by year from 2009 to 2013. The proportion of hospitalization expenses in tertiary medical institutions showed an overall upward trend. The change degree of total hospitalization cost structure was 21.46, and the change degree of sub-item structure was 40.48. The contribution rate of each item structure change of second-level medical institution was the highest. The accumulative amount is 59.73.The items of the first-level medical institutions have a negative change, the individual ego of the second-level medical institutions has a negative change, and the other items have a positive change. Conclusion: the new rural cooperative medical inpatients have the tendency of moving to higher level hospitals. The raising of new rural cooperative medical financing level coexists with the large increase of total medical cost. It is suggested that the medical reform policy should be combined to promote the classification of diagnosis and treatment and limit the excessive increase of medical expenses.
【作者单位】：潍坊市人力资源和社会保障局;潍坊医学院;
【基金】：“健康山东”重大社会风险预测与治理协同创新中心重点研究方向项目(XT1401001、XT1405001) 潍坊医学院科技计划项目(021709)
【分类号】：R197.1;F842.684;F323.89

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