CAJ | 학술논문

目的：分析医保费用增长过快的原因，探讨如何控制医保费用不合理增长。方法提取2011年-2012年度医保出院患者数据进行对比分析实施“医保大额病例管理制度”费用控制情况。结果2012年度在医保出院人数增长为22.66%的情况下，大额出院人数增长率为12.83%。出院均费增长率为2.37%，相比2011年度16.13%的增长率降低了13.76%。结论实施“医保大额病例管理制度”后，医院医保大额费用出院人数增长得以控制，医保出院均费几乎零增长，医院医保出院费用不合理增长得到较好的控制。
목적：분석의보비용증장과쾌적원인，탐토여하공제의보비용불합리증장。방법제취2011년-2012년도의보출원환자수거진행대비분석실시“의보대액병례관리제도”비용공제정황。결과2012년도재의보출원인수증장위22.66%적정황하，대액출원인수증장솔위12.83%。출원균비증장솔위2.37%，상비2011년도16.13%적증장솔강저료13.76%。결론실시“의보대액병례관리제도”후，의원의보대액비용출원인수증장득이공제，의보출원균비궤호령증장，의원의보출원비용불합리증장득도교호적공제。
Objective To analyze the causes of the rapid growth of medical insurance costs, and discuss how to control unreasonable growth.Methods We extracted data of medical insurance patients from 2011 to 2012 and analyzed the cost control of‘medical insurance largedenomination medical record management system’. Results In the case of population growth of medical insurance patients was 22.66%,the rate of population growth of large denomination discharged patients was 12.83%. Discharge average costs growth rate was 2.37%; compared with 2011 the growth rate was reduced from 16.13% to 16.13%.Conclusion population growth of largedenomination discharged patients was controlled after implement of‘medical insurance largedenomination medical record management system’.Medical insurance discharge average costs were almost zero growth. Unreasonable growth about medical insurance costs had been controlled.