城市公立医院综合改革前后某综合性医院职工医保住院费用分析

Analysis on employees medical insurance hospitalization expense in a general hospital before and after urban public hospitals comprehensive reform

[目的]分析城市公立医院综合改革前后某地市级三级甲等综合性医院职工医保住院费用变化情况,为深化医药卫生体制改革提供参考依据。[方法]采用整群抽样的方法对试点医院2014年和2016年66746份职工次均住院费用、次均医保支付费用、个人支付费用的变化进行研究,利用EXCEL表格进行纵向描述分析及相关因素分析。[结果]职工医保住院次均费用增加1.21%,患者个人支付费用减少0.31%;次均药品费减少13.83%,劳务性技术性收入提升25.21%;手术病例个人支付费用增加0.87%,非手术病例个人支付费用下降0.81%;60岁以下病人个人支付费用下降,60岁以上病人个人支付费用增加;男性病人个人支付费用增加,女性病人个人支付费用减少。[结论]城市公立医院综合改革后职工医保住院次均费用有所增加、个人支付费用略有下降,次均药品费下降,劳务技术性收入提升;但改革对不同性别、年龄及是否手术病例的费用影响不同。

Objective To analyze change situation of employees medical insurance hospitalization expense in a third grade general hospital before and after urban public hospitals comprehensive reform so as to provide basis for deepening medical health care system reform.Methods It studied the change of average hospitalization expense,average medical insurance cost and individual expense of 66746 staffs in pilot hospitals in 2014 and 2016 by cluster sampling method.The EXCEL table was used for longitudinal description analysis and correlation factors analysis.Results Average cost of medical insurance hospitalization was increased by 1.21%,individual expense of patients was reduced by 0.31%,average cost of drugs decreased by 13.83%,labor and technical income increased by 25.21%,individual expense of surgical increased by 0.87%,individual expense of non-surgical decreased by 0.81%.The individual expenses of patients under 60 years old were reduced,and the individual expenses of patients over 60 years old were increased.The individual expenses of male patients were increased,and the individual expenses of female patients were reduced.Conclusions After reform of urban public hospital,average cost of medical insurance hospitalization increases,the individual cost decreases slightly,average drug cost decreases,and technical of labor service income increases.But it has different influence in the cost of different sex,age and whether surgical case by the reform.