按项目支付方式对恶性肿瘤参保患者住院费用的影响分析

Impact of the Fee-for-service Payment Method of Urban Basic Health Insurance on Treatment Expenses of Insured Patients with Cancer in China

目的通过分析按项目支付的3个城市恶性肿瘤患者住院费用,探索不同医疗保险管理方式对恶性肿瘤治疗费用的影响。方法从北京、上海、郑州市医保数据库中各随机抽取恶性肿瘤医保患者600名,统计分析其住院费用及其影响因素,并用多元线性回归模型分析次均住院费用的影响因素。结果不同的管理方式对住院费用产生一定的影响,从而对住院费用有不同程度的影响。结论在制定医保管理方法时,不仅要考虑控费效果,还应保障患者合理的就医需要;多种结算方式的综合应用可弥补单一结算方式的不足。

Objective Through taking 3 cities as instance where fee-for service payment method were employed, to investigate and analyze the impact of the payment method on treatment expenses of patients with cancer. Methods Treatment records of 600 cancer patients were acquired from each of the city＇s database via simple random sampling. Key information about the sample was compared by statistic description and simple statistic comparison. Then a multiple linear regression model was employed to analyze the influencing factors of in-patient expenses. Results The manage- ment of payment method had different impact on the expense. Conclusions Cost control is not the only goal for payment management, and proper needs of patient should also be met. All single payment methods had their merits and demerits. A comprehensive payment system, which merged the advantages of different single payment methods, should be tried to explored to provide proper medical service for patients while be controlled.