新农合重大疾病保障政策对单病种医药费用的影响分析

Analysis on the impact of catastrophic disease insurance in the NRCMS on the different types of disease costs

目的:探讨新农合重大疾病保障政策对不同费用类型单病种费用的影响。方法:利用医院信息系统(Hospital Information System,HIS)搜集泰州市人民医院肺癌、食管癌、胃癌、结肠癌、直肠癌手术病人医疗费用等资料,分析新农合重大疾病保障政策实施前后的费用变化。结果:新农合重大疾病保障政策实施后,新农合患者单病种费用明显下降,职工医保患者费用未下降。结论:新农合单病种支付方式改革有利于控制单病种医疗费用,但要使整体医疗费用下降,建议实行疾病诊断相关分类(Diagnosis Related Groups,DRGs)支付。

Objective To explore the influence of catastrophic disease insurance in the New Rural Cooperative Medical Scheme （NRCMS） on the different single - type of disease costs. Methods This paper collected the medical costs data and other information of lung cancer, esophageal cancer, stomach cancer, colon cancer and colorectal cancer patients in The People＇s Hospital of Taizhou based on HIS system, using SPSS software to analysis the changes of different types of patients＇costs before and after the implementation of catastrophic disease insurance of NRCMS. Results After the implementation of catastrophic disease insurance of NRCMS, all single - type of disease costs in NRCMS decreased obviously, but single - type of disease costs in Employee Medical Insurance System did not decrease. Conclusion The reform of single - type of disease payment in NRCMS will control the growth of single - type of disease costs, but the implementation of DRGs payment is able to make the overall medical costs decline.