山东省病人医疗欠费状况调查与对策研究

Surveying the status of medical arrears from patients in Shandong Province and its countermeasures

目的:描述山东省病人医疗欠费现状,分析产生欠费的原因和影响因素,提出预防和减少医疗欠费的建议和措施。方法:采用分层随机抽样方法,抽取356例欠费病例对其欠费情况进行问卷调查和统计学分析。结果:农民和弱势群体是医疗欠费的主要人群,医疗欠费病人大多无任何医疗保险,经济困难是导致病人出现医疗欠费的最主要原因,医疗欠费中近半数的病例属于需要先抢救后付费的类型。结论:进一步扩大社会医疗保障制度覆盖范围,提高医疗救助水平;政府承担补偿责任,减少医疗机构公益性欠费;加强医疗机构自身内部管理;明确欠费责任,加大追偿力度。

Objective To study the status of medical arrears from patients in Shandong Province, analyze the causes and influ- encing factors of medical arrears, and put forward countermeasures. Methods 356 cases of patients were chosen by stratified ran- dom sampling method, and surveyed with questionnaire. Data were statistically analyzed. Results Peasants and vulnerable groups were the main crowd of medical arrears. Most of patients with medical arrears had no medical insurance. And economic difficulty was the main reason of medical arrears. Nearly half of the cases of arrear belonged to the type of ＂first medical rescue and later payment＂. Conclusion The government should enlarge the coverage of medical insurance system, improve medical assistance, and undertake compensation responsibility to reduce medical arrears of public welfare. Medical institutions should intensify internal management mechanism, define liability on medical arrear and strengthen recovery.