某院膝关节置换术单病种付费效果分析

Analysis of the Effect of Single Disease Payment for Knee Arthroplasty in a Hospital

目的 :探讨膝关节置换术单病种付费的效果;方法 :采用回顾分析法,收集某院2016年3月-2018年6月进行膝关节置换术的484例病案资料及费用信息,分为单病种付费组和普通付费组各242例,采取相应的统计学方法对医疗指标占比和报销比例情况进行数据分析,其中医疗指标占比包括对住院天数、住院费用、药占比、手术费占比和医用材料费占比的统计分析。报销比例包括对医保支付占比和自付费用占比情况的统计分析;结果 :通过数据的对比和分析,在医疗指标占比中,单病种付费组与普通付费组人均费用和药占比的结果存在统计学差异(P<0.05)。在报销比例的结果计算中,单病种付费的医疗支付占比较普通付费组高(P<0.05),患者自付费用占比较普通付费组低(P<0.05);结论 :单病种付费有利于控制医保支出,降低医疗费用,帮助患者减轻经济压力,因此单病种付费的方式值得推广,应当结合我国目前医疗卫生发展的具体情况,探索出更加科学、合理的付费管理模式。

Objective:The paper discussed the effect of single disease payment for knee replacement.Methods: Based on retrospective analysis, the medical records and cost information for 484 patients who received knee replacement from March 2016 to June 2018 in X hospital were collected,they were equally divided into single disease payment group and ordinary charge group, the corresponding statistical methods were adopted to analyze the proportion of medical indicators and the proportion of reimbursement, in which the proportion of medical indicators included the statistical analysis of hospital stay, hospitalization expenses, the ratio of drug, surgical expenses and medical materials, the proportion of reimbursement includes the statistical analysis of the ratio of medical insurance payment and self-paying. Results: According to data comparison and analysis, in the proportion of medical indicators,there was a statistical difference between the cost per capita and the ratio of medicine in both groups(P<0.05). The results of the reimbursement ratio suggested that the ratio of medical payment in single disease payment group was higher than that of the ordinary charge group(P<0.05), and the ratio of self-payment in single disease payment group was lower than that of the ordinary charge group(P<0.05). Conclusion: Single disease payment is conducive to controlling expenditure of medical insurance, reducing medical expenses and helping patients to reduce economic pressure, therefore, this method is worth promoting, and it is necessary to explore a more scientific and reasonable payment management pattern based on the development status of medical and health in China.