新医改实施后不同支付方式对山西省某县级医院住院费用的影响

Influence of different payment patterns under the new healthcare system reform on hospitalization expenses in a county-level hospital in Shanxi province

目的 探讨不同支付方式对住院费用的影响,为控制医疗费用快速上涨及医院费用管理提供参考. 方法 分析2011-01 ～2013-10某县级医院21 576例住院患者的费用构成情况及不同支付方式下住院费用的差别.样本均数比较采用方差分析,费用构成比的差异分析采用x2检验. 结果 均次住院费用居民医保住院患者最高,自费住院患者次之,两者均呈上升趋势.新农合住院患者最低且平稳,其比自费住院患者低21.59％,比居民医保住院患者低31.68％.各支付方式下住院费用中药品费用所占比例最高,达28％-43％. 结论 应进一步出台措施对不同支付方式下医疗费用加强管理,控制医疗费用上涨.

Objective To investigate the impact of various payment patterns on hospitalization expenses.Methods Data of 21 576 inpatients in a county-level hospital from January 2011 to October 2013 were collected.Medical expenses under different payment patterns and their structures were analyzed.ANOVA was used to compare means,and chi-square test was used to analyze the constitution of expense.Results The payment patterns for hospitalized expense ranked from the highest to the lowest were urban resident medical insurance,self-funded and new rural cooperative medical system（NCMS）.The expense of the former two kept rising and that of the latter one retained steady.The average expense of NCMS was 21.59％ lower than that of self-funded and 31.68％ lower than that of urban resident medical insurance.Under any payment pattern,the main expense was the drug cost,up to 28％-43％.Conclusion Government must make further steps of managing the payment patterns to control the medical expenses.