总额预付对某医院住院费用的实施效果分析

The Implementation Effect Analysis of Global Budget Payment on a Hospital Inpatients Cost

目的通过比较分析住院费用在总额预付制实施前后的变化情况,探讨总额预付的改革效果,为医保付费方式研究提供基础。方法选取2010年6月—2014年6月的住院次均费用、住院药品次均费用、住院检查次均费用和平均住院日等数据,统计方法用F检验和Wilcoxon秩和检验。结果实施后住院次均费用下降6.99%,药品次均费用下降31.79%,检查次均费用下降15.10%,结果具有统计学差异(P<0.05)。结论总额预付制可以有效降低住院医疗费用、药占比和平均住院日,控制了医疗费用的大幅增长,降低了患者的费用负担,但这种模式仍然存在一定的问题,需要进一步完善。

Objective To compare and analyze the changes of inpatient costs before and after the global budget payment system,exploring the effect of the global budget payment and to provide the basis for medical insurance payment method research.Methods The average inpatient cost,the average inpatient medicine cost,the average inpatient examination cost and the average length of stay from June 2010 to June 2014 were selected,using F-test and Wilcoxon rank sum test to analyze.Results The average inpatient cost has decreased 6.99%,the average inpatient medicine cost has decreased 31.79%,the average inpatient examination cost has decreased 15.10% after the implementation of the global budget.The result is statistically significant(P<0.05).Conclusion The global budget can effectively reduce the inpatient medical cost,drug proportion and average length of stay.It has controlled the substantial increase in medical expenses and reduced patient's cost burden.But this method still has certain problems need to be further improved.