新农合支付方式改革对患者住院均次费用的影响研究

Research of the Influence of Payment Mode Reform of New Cooperative Medical System to Average Hospitalization Expenses

目的通过多种形式的新农合支付方式改革,提高参保人群的受益程度,有效控制患者住院均次费用的不合理增长,促进医疗机构内部运行机制的转变,提高医保资金的使用效率。方法采集不同类别的医疗机构,不同支付方式的住院均次费用的增幅数据,进行改革前后的数据分析。结果改革前后各级各类医院住院均次费用的逐年增幅差距很大,利用支付方式综合改革后的各级各类医疗机构患者住院均次费用得到控制。结论多种形式的支付方式改革是影响医疗机构内部运行机制、降低住院均次费用增幅的有效手段。

Objective To improve the profit level of the people who are insured by the reform of various payment mode of new rural cooperative medical system,to control average medical expenses to increase unreasonably,to promote the transformation of hospital internal operating mechanism,and to improve the service efficiency of medical insurance funds through various forms of New Rural Cooperative Medical System Reform.Method Collecting the increase data of average hospitalization expenses of different payment mode in different medical institutions,and doing data analysis before and after the reform.Results It is found that after the analysis,the gap of the increase of different average hospitalization expenses in different hospitals every year is significant before and after the reform.Average medical expenses in all level medical institutions through payment comprehensive reform are controlled obviously.Conclusion Various payment reform modes are effective methods to influence the internal operating mechanism,and reduce average hospitalization expenses.