摘要
目的了解医保费用分布特征,分析控费方法及效果。方法对2016年和2017年的普通病种、心血管病种和恶性肿瘤病种共25 097病例的低费用率用卡方进行统计分析;以20%的比例抽样调查肿瘤科室和外科科室的低费用原因。结果 2016年和2017年的低费用病例分别是1 694和1 347例,占比分别是13. 9%和10. 4%,两年的低费用率差异性显著(P <0. 05)。低费用原因排在前四位的是化疗、终止诊疗、良性肿物(小)手术和有创检查、检查。结论目标管理是控制疑似低标准住院的有效方法。
Objective To examine the distribution characteristics of medical fee and analyze the effects of the control scheme. Methods A retrospective and statistical analysis was made on the medical expenses of 25 097 cases in 2016 and2017. The reasons for the low medical fee of tumor departments and surgical departments were investigated by sampling at a rate of 20%. Results The low medical fee cases in 2016 and 2017 were 1 694 and 1 347,accounting for 13. 9% and 10.4% respectively,and the difference in two years was significant( P < 0. 05). The first four top circumstances of low fee were chemotherapy,termination of treatment,benign tumor( small) surgeries,invasive procedures or examinations. Conclusion MBO is an effective method in controlling sub-standard admission.
作者
陈惠容
欧凡
蔡锦华
CHEN Huirong;OU Fan;CAI Jinhua(Guangdong Provincial People’s hospital / Guangdong Academy of Medical Science / Guangdong Institute of Geriatrics,Guangzhou 510080,China)
出处
《现代医院》
2019年第9期1299-1302,1306,共5页
Modern Hospitals
基金
广东省医学科学研基金(A2018435)
关键词
目标管理
低标准
控制
Target Management
Low Standard
Control
