医保预付制改革对医院临床科研影响的分析

Influence Analysis of Prepaid Medical Insurance on Clinical Science Research in the Hospital

目的探讨医保预付制改革对医院临床科研工作的影响及应对方法。方法采用SPSS15.0软件对数据进行统计分析,组间率的比较采用χ2检验或Fisher精确概率法。结果2012年6月以前与2012年6—10月相比,新收治乳腺癌病例中医保病例的比例从35.8%下降至28.9%(P=0.029),2012年11月上升至38.2%;随着控制收治医保病例,BC06研究的入组率从19.8%下降至13.2%(P=0.009),其中医保病例入组率从17.3%下降至7.8%,绝对差异下降了接近10.0%,相对差异下降了54.9%(P=0.027),非医保病例的入组率绝对差异则仅下降了6.0%,相对差异仅下降了27.4%(P=0.070)。结论医保预付制改革对医院医保病例收治、临床科研入组等方面造成了一定的影响,应采取相应的措施将此影响降至最低程度。

Objective To investigate the influence of prepaid Data was analyzed through using SPSS15.0, and inter-group medical insurance on clinical science research. Methods comparisons were conducted using χ2 or Fisher＇s test. Results Medical insurance cases took percentage of 28.9% among all newly received patients from June to October, 2012, which was statistically lower （P=0.029） than the percentage of 35.8% before June, 2012. The percentage rose to 38.2% in November. The enrollment rate of RCT BC06 declined from 19.8% to 13.2% （P=0.009）. The enrollment rate of medical insurance cases declined from 17.3% to 7.8%. The absolute difference was approximately 10%, the relative difference was 54.9% （P=0.027）. The absolute difference of the enrollment rate of non-medical insurance cases was 6.0%, and the relative difference was 27.4% （P=0.027）. Conclusion Medical insurance cases mean a great deal to clini- cal science research. Prepaid medical insurance plays a part on reception of medical insurance cases and enrollment of clinical trials. Provision should be carried out to lower the impact.