南京医科大学学报(社会科学版)
南京醫科大學學報(社會科學版)
남경의과대학학보(사회과학판)
ACTA UNIVERSITATIS MEDICINALIS NANJING(SOCIAL SCIENCE)
2014年
4期
280-283
,共4页
芦丰%宋静%孙晓阳%陈树国%冷明祥
蘆豐%宋靜%孫曉暘%陳樹國%冷明祥
호봉%송정%손효양%진수국%랭명상
按病种分值付费%实证研究%淮安市
按病種分值付費%實證研究%淮安市
안병충분치부비%실증연구%회안시
according to the disease score pay%an empirical study%Huaian city
了解淮安市按病种分值付费的实施情况及实施效果,为进一步完善支付方式提供政策参考。采用现场调查表和现场访谈相结合,了解淮安市医保基金运行效率、样本医院整体运行情况及样本医院不同支付方式下单病种的相关情况比较。采用 SPSS14.0统计软件建立数据库并进行分析。淮安市医保基金运行效率、样本医院整体运行情况良好,不同支付方式下单病种的相关情况各异。按病种分值付费在费用控制方面已取得显著成效,将医疗质量指标纳入病种分值考核体系中、不断扩容病种目录并加快更新频次、建立互查互审机制是进一步细化、完善制度的有效方法。
瞭解淮安市按病種分值付費的實施情況及實施效果,為進一步完善支付方式提供政策參攷。採用現場調查錶和現場訪談相結閤,瞭解淮安市醫保基金運行效率、樣本醫院整體運行情況及樣本醫院不同支付方式下單病種的相關情況比較。採用 SPSS14.0統計軟件建立數據庫併進行分析。淮安市醫保基金運行效率、樣本醫院整體運行情況良好,不同支付方式下單病種的相關情況各異。按病種分值付費在費用控製方麵已取得顯著成效,將醫療質量指標納入病種分值攷覈體繫中、不斷擴容病種目錄併加快更新頻次、建立互查互審機製是進一步細化、完善製度的有效方法。
료해회안시안병충분치부비적실시정황급실시효과,위진일보완선지부방식제공정책삼고。채용현장조사표화현장방담상결합,료해회안시의보기금운행효솔、양본의원정체운행정황급양본의원불동지부방식하단병충적상관정황비교。채용 SPSS14.0통계연건건립수거고병진행분석。회안시의보기금운행효솔、양본의원정체운행정황량호,불동지부방식하단병충적상관정황각이。안병충분치부비재비용공제방면이취득현저성효,장의료질량지표납입병충분치고핵체계중、불단확용병충목록병가쾌경신빈차、건립호사호심궤제시진일보세화、완선제도적유효방법。
Objective:To comprehend the implementation of disease score paid and the implementation effect in Huaian city, provide policy references for the further improvement of payment. Methods:By field survey and interview, compared related to operating efficiency, understood Huaian medical insurance fund and sample hospitals' overall operation, and compared different sample hospitals single disease payment. The data were collected and analyzed by SPSS14.0 statistical software. Results:The overall operation efficiency,the medical insurance fund sample hospital were good, the related situation of single entity varied under different kinds of payments. Conclusion:The payment which depended on different entities has achieved remarkable results in cost control, we have already taken the medical quality indicators into the disease score evaluation system, and continuously expanded disease directory and accelerated the update frequency. Establishing mutual check a peer review mechanism is an effective method to further refine, improve system.