CAJ | 학술논문

目的：探索多区域医保统筹费用在医院各专业的预算方式，以便在区域医保统筹费用框架范围内，实施合理的监控。方法根据多个区域医保统筹费的要求，以医院各专业工作量为基础，前瞻性的预算各专业不同区域的医保统筹费用，并模拟跟踪监控。结果通过模拟监控，预算的工作量与预算的各专业医保统筹费用波动一致，预算的各专业医保统筹费用值与半年实际发生值的统计检验无显著差异。结论本预算和模拟监控方法简单便捷、符合实际，可供同行参考和进一步探讨。
목적：탐색다구역의보통주비용재의원각전업적예산방식，이편재구역의보통주비용광가범위내，실시합리적감공。방법근거다개구역의보통주비적요구，이의원각전업공작량위기출，전첨성적예산각전업불동구역적의보통주비용，병모의근종감공。결과통과모의감공，예산적공작량여예산적각전업의보통주비용파동일치，예산적각전업의보통주비용치여반년실제발생치적통계검험무현저차이。결론본예산화모의감공방법간단편첩、부합실제，가공동행삼고화진일보탐토。
Objective To explore the budget method of the overall arrangement of the regional medical insurance expen-ses in each specialty in the hospital, and to monitor properly within the scope of overall arrangement expenses of the regional medical insurance .Methods According to the requirements of multiple regional health care undertakings , on the basis of the workload of each specialty of the hospital , we budgeted prospectively the overall arrangement of the medical insurance expenses of each specialty in different regions, and simulated tracking monitoring.Results Through simulation monitoring, the fluctuation of the budgeted workload was in line with the budgeted overall expenses of the medical insurance of each specialty , and there was no statistical significance in the budgeted values of overall expenses of the medical insurance of each specialty and in the actual values of the half year.Conclusion The method of budget and simulation monitoring is simple, convenient, and realistic, and can provide the reference to peers and further discussion.