摘要
目的 探讨新形势下创新医保管理模式对医疗费用支出及医院服务质量的影响。方法 肇庆市第三人民医院于2019年开始实施创新医保管理模式,选取创新医保管理模式实施前2016—2018年住院患者作为对照组;以及创新医保管理模式实施后,2019—2021年住院患者作为观察组。比较两组患者平均住院时间、次均住院费用、医保超支比例、住院药占比、疾病编码正确率、满意度。结果 观察组平均住院时间为(10.17±1.88)d,短于对照组的(13.98±2.75)d,差异有统计学意义(P<0.05);观察组次均及日均住院总费用、次均住院药品费用及药占比、次均住院自费费用及自费比例低于对照组,差异有统计学意义(P<0.05);观察组医保超支比例、住院药占比低于对照组,疾病编码正确率高于对照组,差异有统计学意义(P<0.05);观察组满意度高于对照组,差异有统计学意义(P<0.05)。结论 新形势下创新医保管理模式可减少不必要的医疗支出并降低患者的自费比例,积极提升医院服务质量、住院患者的满意度。
Objective To explore the impact of innovative medical insurance management mode on medical expenditure and hospital service quality under the new situation.Methods The Third People's Hospital of Zhaoqing City began to implement the innovative medical insurance management model in 2019,and selected the hospitalized patients from 2016 to 2018 before the implementation of the innovative medical insurance management model as the control group;After the implementation of the innovative medical insurance management model,the hospitalized patients from 2019 to 2021 were used as the observation group.The average length of stay,the average cost of hospitalization,the proportion of medical insurance overspending,the proportion of inpatient drugs,the correct rate of disease coding and the satisfaction of the two groups were compared.Results The average hospitalization time in the observation group was(10.17±1.88)d,which was shorter than that in the control group(13.98±2.75)d,and the difference was statistically significant(P<0.05).The average and average daily inpatient cost,average inpatient drug cost and drug proportion,average inpatient out-of-pocket cost and out-of-pocket proportion in observation group were lower than those in control group,and the differences were statistically significant(P<0.05).The proportion of medical insurance overspending and inpatient drug in the observation group was lower than that in the control group,and the correct rate of disease code was higher than that in the control group,with statistical significance(P<0.05).The satisfaction of observation group was higher than that of control group,and the difference was statistically significant(P<0.05).Conclusion Under the new situation,the innovation of medical insurance management mode can reduce unnecessary medical expenditure and reduce the self-expense ratio of patients,and actively improve the service quality of hospitals and the satisfaction of inpatients.
作者
马月丽
赵燕华
MA Yue-Li;ZHAO Yan-Hua(Medical Insurance Office,The Third People's Hospital of Zhaoqing City,Zhaoqing 526060,China;Department of Medical Records,The Second People's Hospital of Zhaoqing City,Zhaoqing 526060,China)
出处
《中国药物经济学》
2024年第9期91-94,共4页
China Journal of Pharmaceutical Economics
基金
肇庆市科技创新指导类项目(201904031520)。
关键词
创新医保管理模式
医疗费用支出
医院服务质量
患者满意度
Innovative medical insurance management mode
Medical expenses
Hospital service quality
Patient satisfaction
