解放军医院管理杂志
解放軍醫院管理雜誌
해방군의원관리잡지
HOSPITAL ADMINISTRATION JOURNAL OF CHINESE PEOPLE'S LIBERATION ARMY
2015年
2期
101-102
,共2页
病案质量指标%医保支付管理因素%相关分析
病案質量指標%醫保支付管理因素%相關分析
병안질량지표%의보지부관리인소%상관분석
medical record quality index%medical insurance payment management factors%correlation analysis
目的：分析探讨医院病案质量指标和医保支付管理因素的相关性。方法采用随机抽样法选取2013年2月—2014年4月于本院住院治疗的急性心肌梗塞、子宫肌瘤与急性阑尾炎患者247例为研究对象，回顾性分析其临床资料，按照病案质量改进情况将其分为 A、B 两组。 A 组患者病案质量持续改进，B 组患者的病案质量维持现状，比对分析两组患者医保支付率、公费率、自费率及住院天数。结果①A 组患者医保支付率、公费率及自费率各为59．9％、12．9％和27．2％，B 组则为43．0％、7．0％和50．0％，A 组医保支付率明显高于 B 组患者，组间对比具有差异，P ＜0．05；②A组医保支付患者平均住院时长分别为急性心肌梗塞患者（13．1±2．6）天，子宫肌瘤患者（16．6±3．4）天，急性阑尾炎患者（7．3±2．2）天，B 组医保支付患者平均住院时长分别为急性心肌梗塞患者（15．7±2．9）天，子宫肌瘤患者（18．5±4．1）天，急性阑尾炎患者（9．0±3．1）天，A 组患者平均住院时长均短于 B 组，组间对比具有统计学意义，P＜0．05。结论病案质量与医保支付率呈正相关性，病案质量越高，医保支付率越高；且医保支付患者中，病案质量越高，资源利用率与医院服务质量越高，患者住院时间越短。
目的：分析探討醫院病案質量指標和醫保支付管理因素的相關性。方法採用隨機抽樣法選取2013年2月—2014年4月于本院住院治療的急性心肌梗塞、子宮肌瘤與急性闌尾炎患者247例為研究對象，迴顧性分析其臨床資料，按照病案質量改進情況將其分為 A、B 兩組。 A 組患者病案質量持續改進，B 組患者的病案質量維持現狀，比對分析兩組患者醫保支付率、公費率、自費率及住院天數。結果①A 組患者醫保支付率、公費率及自費率各為59．9％、12．9％和27．2％，B 組則為43．0％、7．0％和50．0％，A 組醫保支付率明顯高于 B 組患者，組間對比具有差異，P ＜0．05；②A組醫保支付患者平均住院時長分彆為急性心肌梗塞患者（13．1±2．6）天，子宮肌瘤患者（16．6±3．4）天，急性闌尾炎患者（7．3±2．2）天，B 組醫保支付患者平均住院時長分彆為急性心肌梗塞患者（15．7±2．9）天，子宮肌瘤患者（18．5±4．1）天，急性闌尾炎患者（9．0±3．1）天，A 組患者平均住院時長均短于 B 組，組間對比具有統計學意義，P＜0．05。結論病案質量與醫保支付率呈正相關性，病案質量越高，醫保支付率越高；且醫保支付患者中，病案質量越高，資源利用率與醫院服務質量越高，患者住院時間越短。
목적：분석탐토의원병안질량지표화의보지부관리인소적상관성。방법채용수궤추양법선취2013년2월—2014년4월우본원주원치료적급성심기경새、자궁기류여급성란미염환자247례위연구대상，회고성분석기림상자료，안조병안질량개진정황장기분위 A、B 량조。 A 조환자병안질량지속개진，B 조환자적병안질량유지현상，비대분석량조환자의보지부솔、공비솔、자비솔급주원천수。결과①A 조환자의보지부솔、공비솔급자비솔각위59．9％、12．9％화27．2％，B 조칙위43．0％、7．0％화50．0％，A 조의보지부솔명현고우 B 조환자，조간대비구유차이，P ＜0．05；②A조의보지부환자평균주원시장분별위급성심기경새환자（13．1±2．6）천，자궁기류환자（16．6±3．4）천，급성란미염환자（7．3±2．2）천，B 조의보지부환자평균주원시장분별위급성심기경새환자（15．7±2．9）천，자궁기류환자（18．5±4．1）천，급성란미염환자（9．0±3．1）천，A 조환자평균주원시장균단우 B 조，조간대비구유통계학의의，P＜0．05。결론병안질량여의보지부솔정정상관성，병안질량월고，의보지부솔월고；차의보지부환자중，병안질량월고，자원이용솔여의원복무질량월고，환자주원시간월단。
Objective To analyze the correlation of medical record quality indicators and medical insur -ance payment management factors in hospital .Methods 247 patients including acute myocardial infarction , uter-ine fibroids and acute appendicitis were researched using random sampling method in February 2013 to April 2014 in our hospital.They were divided into two groups included group A and group B according to the medical record quality improvement.Group A was improved with medical record quality continuous , while group B was remain un-changed.A study was compared among medical insurance , self -paying, government insurance and hospitalization time.Results ①Medical insurance, self -paying and government insurance of group A were 59.9%, 12.9%and 27.2%,while group B were 43.0%, 7.0% and 50.0%, and group A was significantly higher than group B (P<0.05); ②The average hospitalization time of group A were that acute myocardial infarction (13.1 ±2.6 d), uterine fibroids (16.6 ±3.4 d) and acute appendicitis (7.3 ±2.2 d), while group B were that acute myocardial infarction (15.7 ±2.9 d), uterine fibroids (18.5 ±4.1 d) and acute appendicitis (9.0 ±3.1 d), and group A was significantly Shorter than group B (P <0.05).Conclusion Medical record quality and medical insurance payment rate is positively correlation, the higher the quality of medical record, medical insurance payment rate is higher; And patients with medical insurance payments , the higher the quality of medical record, the resource utili-zation and quality of hospital services is higher , average length of stay is shorter.
