单病种定额付费在肿瘤专科医院的运行效果分析

Implementation of Quota Payment for Single Disease in Tumor Specialized Hospital

[目的]分析单病种定额支付对肿瘤专科医院收入、结余及医疗服务质量的影响。[方法 ]采用回顾性分析和满意度调查问卷相结合的方式,选取浙江省肿瘤医院2017年1月至2018年12月甲状腺恶性肿瘤、乳腺恶性肿瘤、宫颈上皮内肿瘤3个病种共923例相关数据,对医院单病种付费前后相关指标进行对比分析。并选取50名主管医生,向其发放满意度调查问卷。[结果]采用单病种定额支付后住院天数平均缩短2.06d,人均床日费用平均提高7.05%,定额偏离率均数为-3.51%,医生满意度均有不同程度的提升,差异均有统计学意义(P<0.05)[结论]单病种定额付费基本控制了住院费用的不合理上涨,对医疗服务行为起到一定的规范作用,医生满意度有不同程度的提升。

[Purpose]To analyze the impact of quota payment for single disease on the income,balance and medical service quality in cancer specialized hospital.[Methods]Total 923 cases of thyroid cancer,breast cancer and cervical intraepithelial neoplasms treated in Zhejiang Cancer Hospital from January 2017 to December 2018 were selected as study subjects.The related indicators before and after implementation of quota payment for single disease were compared.A questionnaire survey on the satisfaction was conducted among 50 doctors in charge.[Results]After implementation the quota payment for single disease the average length of hospital stay was shortened by 2.06 d,the average cost of bed-day per patients was increased by 7.05%,and the average deviation rate was-3.51%.The satisfaction of doctors was improved significantly in varying degrees(P<0.05).[Conclusion]Quota payment for single disease basically controls the unreasonable increase of hospitalization expenses,plays a normative role in medical service behavior,and improves doctors’satisfaction to varying degrees.