CAJ | 학술논문

目的对新农合即时结算系统等提供的数据进行统计分析,为新农合的健康发展提供资料.方法分析2010年-2012年544例新农合剖宫产病人的住院费用和实际补偿金额状况.结果新农合政策的报销比例的提高,增加了患者的实际补偿金额,由1646.19元/例均上升到1877.06元/例均;缩短例均住院天数,降幅为37.02%;降低例均住院费用,降幅为13.4%;由于存在不合理用药和检查,导致了不必要的费用支出.结论扩大新农合基本药物和诊疗项目的使用,提高新农合患者的补偿费用.降低新农合患者个人自费金额的比例;减少使用新农合政策目录外费用的比例.
목적대신농합즉시결산계통등제공적수거진행통계분석,위신농합적건강발전제공자료.방법분석2010년-2012년544례신농합부궁산병인적주원비용화실제보상금액상황.결과신농합정책적보소비례적제고,증가료환자적실제보상금액,유1646.19원/례균상승도1877.06원/례균;축단례균주원천수,강폭위37.02%;강저례균주원비용,강폭위13.4%;유우존재불합리용약화검사,도치료불필요적비용지출.결론확대신농합기본약물화진료항목적사용,제고신농합환자적보상비용.강저신농합환자개인자비금액적비례;감소사용신농합정책목록외비용적비례.
@@@@Objective To conduct statistical analysis on the basic data from instantaneous settlement of new rural cooperative med -ical system ,so as to decrease the hospitalization expenses and increase the amount of compensation of cesarean patients .Methods We analyzed the expenses of hospitalization and compensation proportion of 544 cesarean cases in new rural cooperative medical system from 2010 to 2012 .Results It indicates that under the policy of new rural cooperative medical system ,the actual compensation amount for cesarean patients is increased as the increasing of compensation proportion ,and the actual average compensation amount has increased from 1646 .19 to 1877 .06 per case .With the decrease of generally average hospitalized time ,the hospitalization expens-es has decreased 37 .02% ,with the decrease of hospitalization expenses of per case ,it has decreased 13 .4% .However ,because of the existing of inappropriate medication and checkup ,some unnecessary expenses were followed .Conclusion Therefore ,it is neces-sary to take more advantage of the basic medication and checkup projects under new rural cooperative medical system ,so as to increase the compensation amount for patients .It is also recommended to reduce the percentage of patient self-responsible payment amount ,as well as the expense percentage of policy categories that are not included in the new rural cooperative medical system .