专科医院医保住院患者外院就诊流程的分析与思考

Analyze and Reflection of External Hospital Process in Specialist Hospital Medical Insurance Patients

目的针对专科医院医保住院患者外院就诊情况进行分析,为制定合理的术前检查方案提出参考建议。方法以我院2015年1~4月医保住院患者为研究对象,对其间发生的外院就诊人数、结构、费用及可控情况进行分析。结果通过对本院2015年1~4月出院医保患者进行数据统计分析得出：（1）目前我院外院就诊人数占医保住院患者的42.20%;（2）对外院检查费用结构分析得出：前三项检查人数占外院检查人数的96.27%;（3）外院检查费用对住院次均费用的平均影响率为4.51%。结论建议将常见的前三种外院就诊情况前置到患者住院前进行,从而达到缩短医保住院患者平均住院日、降低住院次均费用、提高医院病床周转率、减轻患者及家属的经济负担、提高医院的服务质量,进而对解决社会上目前存在的看病难、看病贵的难题起到重要作用，

Objective To make rationalize preoperative examination plan by analyzing the external hospital process in specialist hospital patients who has medical insurance. Methods We analyzed the number, structure, cost and controllable condition of external hospitalize patients who has medical insurance during January 2015 to April 2015 in Beijing Stomatological Hospital. Results After we analyzed the statistics data of patients who has medical insurance, we concluded that：（1）The numbers of external hospitalize patients accounted for 42.20% of patients who has medical insurance.（2） The numbers of first three items of external hospitalize structure accounted for 96.27% of external hospitalize patients.（3） The average influence ratio of for external hospitalize expense for the average hospitalization expense was 4.51%.Conclusion We advise the patients who have the first three situations should take the examinations in external hospital in order to shorten the preoperative average length of stay, decrease average hospitalization expense, increase hospital bed turnover rate, and improve the hospital service quality. Additionally, relieve the problem of the difficulty and high cost of getting medical service.