某高校医院医保后门诊状况分析

Analysis on the out-patient status of university hospitals after the implementation of medical insurance

目的考查某高校医院医保后的门诊状况,分析其中存在的问题,为高校医疗保障工作提供借鉴。方法将门诊对象分为学生组和教职工组,采用定量分析法考查2010~2015年校医院就诊人次和金额变化,以2011年和2013年为例分析处方排名前15位的药品状况。结果医保后医疗费用大幅增长的趋势得到扭转,药品使用更加规范合理;但校医院门诊量出现显著下降,医疗设备闲置状况较严重,经营面临竞争和挑战。结论实施医保节省了校方和国家的医疗报销费用,提高了校医院的合理用药水平;高校医院可建立起师生健康管理和干预系统,提升卫生服务内涵;向社会开放,结合社区服务理念到实际工作中;加强与大医院的合作,以求得更好的生存和发展。

Objective To investigate the status of outpatient service in a university hospital after the implementation of medical insurance and to analyze the existing problems in it, hence to provide references for medical security work in colleges and universities. Methods The objects of outpatient service were divided into student group and staff group. Quantitative analysis method was used to investigate changes in both the number and sum of money of outpatient visits to the university hospital from 2010 to 2015. And the situation of top 15 medicines in the list of prescription was ana- lyzed by the example of the year 2011 and 2013. Results After the implementation of medical insurance, the quick up- ward trend of medical expenses was reversed, and prescriptions turned to be more rational and more standard. But the hospital outpatient amount decreased substantially, and medical equipments were in serious low utilization. The opera- tions of university hospitals were facing competitions and challenges. Conclusion The implementation of medical insur- ance saves both the university and the country＇s medical expenses, and improves rational use of drugs in the university hospital. To achieve better survival and developments, college or university hospitals may establish health management and intervention system for the students and teachers to improve the connotation of medical service, open to the society and incorporate concepts of community health service into its practical work, and strengthen its corporations with large hospitals.