湖北省某县不合理入院对新型农村合作医疗住院基金使用效率的影响

Effects of the Inappropriate Admission Patients under New Rural Cooperative Medical System on the Use Efficiency of Hospital Fund in a County,Hubei

目的:研究新农合参合者不合理入院对住院基金使用效率的影响,为控制患者不合理入院,扩大参合农民受益水平提供依据。方法:采用分层整群抽样调查湖北省荆门市某县一个县级医院和两个乡镇卫生院的患者不合理入院水平及费用情况。结果:乡镇卫生院不合理入院率比县级高出0.87%;县、乡两级不合理入院病例产生的平均不合理费用分别为824.27元、581.28元,县、乡不合理费用实际报销水平占医院1-6月份所有住院病例新农合实际报销费用的比例分别为4.12%、6.81%。结论:深度挖掘不合理入院原因的不同"亚型",理性控制"过度医疗";强化需方和供方的费用控制意识,加强行医过程费用监督,实行药品管理与绩效考核相结合。

The purpose is to control unreasonable admission to maximize resource utilization, to expand the ginseng adds up farm- er benefit level provide reasonable basis. Methods：Using stratified cluster sampling method to survey the unreasonable admission level and cost of a county hospital and two township health centers in Jingmen, Hubei. Results： The inappropriate admission rate of township hospital above the county level is 0.87% higher. The actual expense cost account to 4.12% ,6.81% in all investigation of the corresponding level hospital 1 -6 ca- ses. Conclusion： To strengthen the rural community health service construction, and improve the drug quantity and quality of township hospital, im- plement ＂admission responsibility system＂of performance bonus deductionreward.