摘要
针对近年来县级医院城镇职工医保住院统筹支付费用逐年增长的压力,为深入剖析其中不断上涨的原因,对不同类型常见单病种住院费用进行比较,并分析三种不同医疗保险支付方式下,相同疾病和治疗方式患者住院费用的差异性及其影响因素,结果显示三种医保的住院费用、次均费用、次均药品、次均"三费"等均存在差异。建议医院应积极引导群众合理就医、降低住院率,大力推行临床路径,并结合按病种付费管理,降低次均费用,建立临床科室医保员制度和切实可行的医保管理考核办法,从而减轻城镇职工住院统筹支付超支的压力。
In view of the tact that in recent years the cost ot hosp^tallzatlon tor medical insurance m uroan hospitals has been increasing year by year growing pressures, in-depth analysis of which the reasons for rising, will be different types of common single disease type hospitalization costs were compared and analyzed under three different medical insurance payment methods, phase the differences of hospitalization expenses and the influencing factors between the patients.the results showed that the three kinds of health insurance hospitalization costs,the average cost,the average number of drugs,the average＂three fees＂and so there are differences.the patients with diseases and treatment methods suggested that the hospital should and actively guide the masses to a reasonable medical treatment, reduce hospitalization rate,vigorously implement the clinical path, combined with payment by disease management, reduce the average cost. The establishment of clinical departments of medical insurance system,buih the establishment of practical measures for the management of health insurance assessment, thereby reducing the urban workers in hospital co-ordination to pay over the pressure of the branch.
作者
何静云
吕颖
HE Jing-yun LV Ying(Jing County Hospital of Anhui Province, Jingxian 242500,Anhu)
出处
《安徽卫生职业技术学院学报》
2017年第1期8-9,共2页
Journal of Anhui Health Vocational & Technical College
关键词
职工医保
新农合
费用管理
县级医院
Medical insurance
Aagricultural
Cost management
County hospital
