运用单病种诊断与费用消费系数进行拨款改革

Applying the index of simple disease diagnosis and cost consumption in the reformation of appropriations allocation

军队医疗费用拨款制度是按编制的床位数及住院日进行的。很难适应当前医院发展实际需要。目的 :探讨不同条件下医疗费用的偿付标准。方法 :对近 30 0家军队医院的 2 70万份电子病历信息进行数理统计分析 ;建立各种疾病间的消费系数及各种因素条件下的加权系数 ;建立一套利用系数实现经费拨款的办法和配套公式 ,提出解决特殊病例拨款的一些作法和经验 ,并对有关病种的合理收费标准进行了评估。结论 :单病种诊断与费用消费系数拨款方法改革不仅有助于国内目前医疗卫生事业改革的测算 ,并可为各级医院有关医疗费用的合理收取提供参考。

The allocation system of military medical appropriations has been runing according to the number of beds, which was corresponding with military establishment and the time of patients in hospital. It is difficult for system to adapt to the need of current real development of hospitals. Objective:To study the paying criteria of medical cost under different conditions. Methods: The data of 2,700,000 electronic case records in 300 military hospitals were statistic ally analyzed, and the weigh coefficient of consumption system among every kind of disease under different conditions and a series of means and corresponding formalas to realize cost appropriations with the coefficient were established. Some methods and experiments of appropriations for solving specific cases were described and reasonable critera of collecting fees about associated kinds of diseases were evaluated. Results: The reform in the methad of allocating of appropriations according to the index of simple disease and cost consumption is not only helpful in the measurement of current reform in domestic medical service but may be refarred to in also reasonable collecting reasonable fees in every grade hospital.