基于参与约束条件的按人头付费支付标准测算

Research on Payment Standard of Capitation Based on Participation Constraint

目的:估测按人头付费支付标准.方法:统计分析和信息经济学中的参与约束条件.结果:按人头付费支付标准其由分担的保留效用、患病的平均治疗成本和弥补医院亏损的风险成本三部分构成.结论:为了更好实行按人头付费,需要加大参保人员人数、无差异的接纳参保人员以及并对医院的医疗服务质量进行监督,并根据保障范围、时间、质量等因素对支付标准进行调整.

Objective: To establish the payment standard of capitation. Methods: participation constraints in statistical analysis and information economics were applied. Results: The payment standard of capitation included three parts: the shared retention utility, the average treatment cost of illness and the risk cost of making up the loss of the hospital. Conclusion: To better implement capitation, it was necessary to increase the number of insured personnel, accept them indiscriminately, and supervise the quality of medical services in hospitals, and reasonably determine the payment standard according to the factors of coverage, time and quality.