摘要
目的观察军队医疗保障制度改革的成效及其对军队人员住院情况的影响。方法选取某军队医院医疗保障制度改革前1年和医疗保障制度改革后5年出院的军队人员为研究对象,采用χ2检验、Kruskal Wallis Htest秩和检验、统计图以及描述性分析等方法,对比分析该军队院医疗保障制度改革前后医疗质量、医疗效率及医疗保障水平的变化情况。结果①医疗质量:近6年该军队医院医疗质量保持较高水平,医疗改革后医疗质量均高于标准水平,总体保持逐年递增的态势。②医疗效率:医疗保障制度改革前后该军队医院军队人员住院天数比较存在显著性的差异,平均住院日逐年下降(P<0.01);6年来该军队医院不断缩短术前平均住院日,将其由医疗保障制度改革前的4.81 d降到医疗保障制度改革后5年的4.05 d,使患者能够得到及时的诊治。③医疗保障水平:医疗保障制度改革前后该军队医院军队人员出院人次有显著性的差异(P<0.01),医疗保障制度改革后师职干部出院人次增加,团职以下干部、战士、职工和家属出院人次不断减少。医疗保障制度改革后军队人员日均住院费用及次均费用呈上升趋势,药品费用比例逐年增加,治疗费用比例也有所上升,检查、化验费用比例变化不明显。结论军队医疗保障制度改革后,分类保障模式运行良好,医疗保障水平稳步提高,医疗费用结构有待进一步完善。
Objective To explore the effect of military health care system reform on military personnel medical care.Methods Study subjects were military personnel who were discharged from a certain hospital 1 year before and 5 years after the military health care reform.Their health care quality,efficacy and medical expense were compared and analyzed by using χ2 test、Kruskal Wallis H test、statistical chart and analysis of delineation.Results ①Quality of medicare： the medicalcare quality had been at a high level during the recent 6 years,and was higher than nomal after the reform,with increasing progressively year by year.②Efficiency of medicare： The hospital stay showed significant difference before and after treatment,and the mean hospital stay decreased year by year（P0.01）;the average preoperative hospital stay was constantly reduced during the 6 years,with 4.81 d before reform to 4.05 d after reform,wich provides patients with timely surgery treatment.③Level of medicare： man-time discharged from hospital showed significant difference before and after the reform（P0.01）.Numbers of officers with the ranks of senior colonels discharged from the hospital increased after reform,but the number of those below the senior colonel ranks and dependents decreased;the cost of hospitalization per day and every time showed a ascending trend;medical expense proportion was increased year by year,and treatment expense proportion was certainly increased at the same time,while physical and laboratory examination expense proportion had not changed much. Conclusion Medical care reform with hierarchy classification has been in place;health care quality has seen steady improvement but the structure of hospitalization expenditure needs to be further improved.
出处
《解放军医药杂志》
CAS
2011年第1期83-85,110,共4页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
关键词
医院
军队
卫生保健改革
军队卫生
军事人员
Hospital
armed forces
Health care reform
Military hygiene
Military personnel
