CAJ | 학술논문

目的:回顾上海市杨浦区2011—2012医疗保险年度部分当面审核人员的情况,初步分析其违规的原因.方法:对179例门诊当面审核人员的情况进行回顾性分析.结果:参保人因素是导致违规的主要原因(P<0.05),波立维等心脑血管病类药物是导致违规的主要药物(P<0.05).结论:医疗保险违规问题仍较为严重,医疗保险监督和慢性非传染性疾病的防治任重而道远.
목적:회고상해시양포구2011—2012의료보험년도부분당면심핵인원적정황,초보분석기위규적원인.방법:대179례문진당면심핵인원적정황진행회고성분석.결과:삼보인인소시도치위규적주요원인(P<0.05),파립유등심뇌혈관병류약물시도치위규적주요약물(P<0.05).결론:의료보험위규문제잉교위엄중,의료보험감독화만성비전염성질병적방치임중이도원.
Objective: To review general circumstance of the present investigation staffs of Yangpu District, Shanghai in 2011-2012 medical insurance year, and make a preliminary analysis of the reason of deregulation. Methods: Conducting a retrospective analysis of 179 cases of outpatient present investigation staffs. Results:Factor of the insured person is the main reason causing the deregulation (P<0.05). Plavix and other cardiovascular and cerebrovascular drugs lead to the deregulation (P<0.05). Conclusion:Situation of medical insurance deregulation is still very serious. Supervision, and the prevention and treatment of chronic non-infective diseases have a long way to go.