按病种分值付费控制住院费用及住院日的效果分析

Effectiveness analysis on control in the patients′hospitalization costs and hospitalization days under the system of payment by disease score

目的探讨实施按病种分值付费政策控制病人住院费用和住院日的效果。方法利用病案首页关键信息与医保结算费用,对按病种分值付费实施前后的住院费用、住院日、费用结构、城乡或职工医保病人费用等指标进行比较分析。结果实施病种分值付费后平均住院费用、平均住院日均比实施前降低,差异均有统计学意义(P<0.05);病人费用结构中药品费、耗材费、其他费均下降,技术劳务费提高,差异均有统计学意义(P<0.05)。结论按病种分值付费可有效降低患者平均住院费用和平均住院日,促进结构费用优化,但在职工医保病人控费方面仍需加强。

Objective To explore the effect of implementing the policy of payment by disease score to control the patients′hospitalization costs and hospitalization days.Methods By using the key information in the medical record homepage and medical insurance settlement fee,this paper makes a comparative analysis on the indicators of hospitalization costs,hospitalization days,the cost structure,and medical insurance costs of urban or rural patients before and after the implementation of payment by disease score.Results The average hospitalization costs and average hospitalization days were lower than those before the implementation of payment by disease score,and the differences were statistically significant(P<0.05).In the patient cost structure,drug cost,consumable cost and other costs all decreased,while technical labor cost increased,and the difference was statistically significant(P<0.05).Conclusion The payment by disease score can effectively reduce the average hospitalization costs and average hospitalization days,and promote the optimization of the structure cost,but it still needs to be strengthened in the aspect of controlling the cost of urban medical insurance patients.