单病种模式下新农合住院费用影响因素研究

An Analysis on Influencing Factors of Hospitalization Expenditure Under the Single DRGs Mode

以陕西省旬邑县为例,分析单病种定额付费模式下新农合的运行效果及新农合住院费用的影响因素。旬邑县自2006年开始进行"住院单病种定额付费"模式改革后的新农合住院补偿的历年变化表明,新农合住院补偿受益面逐年扩大,次均住院费用年增长率高低不一,是否属于单病种住院、就诊医疗机构等是新农合住院费用的影响因素。基于此,要进一步提高新农合实际住院补偿比例,继续完善"住院单病种定额付费"模式。

In order to analyze the operating effect and influencing factors of hospitalization expenditure of NRC- MS under the payment mode of single DRGs, Xunyi County is taken as an example to analyze the changing condition by yearly hospitalization compensation after the reform of payment mode of single DRGs since 2006. And we analyze the influencing factors of hospitalization expenditure using the method of logistic regression based on the hospitalizationdetailed data of 2012. It shows that the benefit scope of hospitalization compensa- tion of NRCMS of Xunyi County is expanding by yearly, the annual growth rates of hospitalization expense per time are not sureto high or low, and whether it belongs to single DRGs, hospitalization medical institutions etc. are the influencing factors of hospitalization expenditure of NRCMS. Based on above, we suggest that it should improve the actual ratio of hospitalization compensation further and continue to perfect the payment mode of hospitalization single DRGs.