医疗保险支付方式改革对费用控制的影响——以浙江省嵊州市新型农村合作医疗制度为例

On the influence of the reform of medical insurance payment on the charge control——A case study of the new rural cooperation medical system of Shengzhou City of Zhejiang province

以浙江省嵊州市新型农村合作医疗制度为例,探究医疗保险支付方式改革对费用控制的影响,发现嵊州市自2011年实行"按服务单元付费和总额预算、弹性决算"的结算方法后,患者的年平均看病费用支出和年平均门诊费用支出均有明显下降,这证明了医疗保险付费方式从后付制转为预付制后,合理控制了医疗费用的支出。并就调查过程中发现的问题提出相关建议。

Taking the new rural cooperation medical system of Shengzhou City of Zhejiang province,this paper probes into the influence of the reform of medical insurance payment on the charge control,finding out that after implementing the settlement method of paying fee according to service unit and total budget and flexible final account,the patients＇ average annual payments for sickness and average annual outpatient service expenses markedly dropped in Shengzhou City since 2011,which proves that after the medical insurance payment changed from after-payment system to the pre-payment system,the payment of medical expenses is reasonably controlled.It puts forward some suggestions.