CAJ | 학술논문

目的：分析某三级医院新农合总额预付前后医疗服务的变化。方法收集某三级医院2011年和2013年医院运营数据及病历首页数据，分析新农合总额预付前后医院住院人数、住院费用、病种结构等方面的变化。结果新农合总额预付降低了医院住院病人和医疗费用的增长幅度，在一定程度上提高了三级医院住院病人结构的疑难复杂程度，但基金分摊方式的不完善使医院需要垫付大笔资金，使医院面临经济风险。结论新农合总额预付能在一定程度上控制医疗支出，提高医院管理水平，但该制度和其他配套措施还需进一步完善。
목적：분석모삼급의원신농합총액예부전후의료복무적변화。방법수집모삼급의원2011년화2013년의원운영수거급병력수혈수거，분석신농합총액예부전후의원주원인수、주원비용、병충결구등방면적변화。결과신농합총액예부강저료의원주원병인화의료비용적증장폭도，재일정정도상제고료삼급의원주원병인결구적의난복잡정도，단기금분탄방식적불완선사의원수요점부대필자금，사의원면림경제풍험。결론신농합총액예부능재일정정도상공제의료지출，제고의원관리수평，단해제도화기타배투조시환수진일보완선。
Purpose To analyze the medical care changes before and after global budget of New Rural Cooperative Medical System (NCMS) in a tertiary hospital. Methods Data on hospital operation and medical records from 2011 to 2013 were collected, and the number of hospital inpatients, hospitalization expenses, disease structure and some other aspects before and after global budget were analyzed. Results The global budget of NCMS decreased the growth rate of hospital inpatients and medical expenses, improved the complexity of patient’s structure in this tertiary hospital in a certain degree. However, the non-perfect fund allocation made the hospital pay large sums of money, resulting in economic risks for the hospital. Conclusion The global budget of NCMS can control the medical expenses and improve the management level in a certain degree, but this system and other necessary management measures should be further improved.