中国医院
中國醫院
중국의원
CHINESE HOSPITALS
2013年
9期
10-12
,共3页
黄玲萍%王锦福%于广军%杨中浩%杨丽%厉传琳%王永芝
黃玲萍%王錦福%于廣軍%楊中浩%楊麗%厲傳琳%王永芝
황령평%왕금복%우엄군%양중호%양려%려전림%왕영지
医疗保险%总额预付%三级医院%医疗收入结构
醫療保險%總額預付%三級醫院%醫療收入結構
의료보험%총액예부%삼급의원%의료수입결구
medical insurance%global budget%tertiary hospitals%the structure of medical income
研究2008-2011年上海部分市级公立医院相关经济数据，发现实施医保总额预付后，试点医院医疗收入结构有显著变化，医疗收入结构中自费比重出现普遍上升，且门诊及住院收入结构中自费比重上升的形成原因有所差异。预付制试点医院的医疗收入结构变化以及药费控制效果等较非试点医院较为明显，重要影响因素是总额预算向总额预付的制度改进强化了医院管理者对医保控费的政策预期。
研究2008-2011年上海部分市級公立醫院相關經濟數據，髮現實施醫保總額預付後，試點醫院醫療收入結構有顯著變化，醫療收入結構中自費比重齣現普遍上升，且門診及住院收入結構中自費比重上升的形成原因有所差異。預付製試點醫院的醫療收入結構變化以及藥費控製效果等較非試點醫院較為明顯，重要影響因素是總額預算嚮總額預付的製度改進彊化瞭醫院管理者對醫保控費的政策預期。
연구2008-2011년상해부분시급공립의원상관경제수거，발현실시의보총액예부후，시점의원의료수입결구유현저변화，의료수입결구중자비비중출현보편상승，차문진급주원수입결구중자비비중상승적형성원인유소차이。예부제시점의원적의료수입결구변화이급약비공제효과등교비시점의원교위명현，중요영향인소시총액예산향총액예부적제도개진강화료의원관리자대의보공비적정책예기。
This paper gives an analysis of the economic data of shanghai municipal public hospital from 2008 to 2011. The finding is that the structure of hospital’s medical income has changed and the patient self-payment proportion of health expenditure in hospital has risen universally, after the implementation of global budget and prepayment pilot. The formation mechanism of medical income structure’s changes between outpatient section and inpatient section is different. The changes of medical income structure and the effect of drug expenditure control have be more obvious for pilot hospital than non-pilot hospital, and the main reason is that the system reformation from total budget to prepayment has strengthened policy expectations of health expenditure control to hospital managers.
