| 摘要: |
| 目的 比较济宁市各级各类医疗机构的医疗服务、质量、效率、费用等关键要素变化，为完善“先看病后付费”诊疗服务模式提供参考依据。方法 选取济宁市266家各级各类医疗机构为调查对象，采用自行设计的“济宁市‘先看病后付费’工作推广效果评估调查表”进行问卷调查，同时分层抽样15家医院进行现场访谈。结果 济宁市享受“先看病后付费”住院患者惠及率达到59.45%，年增加37.29%；全市各级各类医疗机构全面实施了此项制度，二级及以下医疗机构惠及率高于三级医疗机构，分别达到77.18%、63.71%。结论 “先看病后付费”服务模式改革，满足了群众医疗需求，医保（新农合）住院患者总费用得到合理控制，患者自付就医经济负担进一步减轻。为规避风险，提出解决垫付资金和恶意欠费问题解决方案。 |
| 关键词: 先看病后付费，医疗服务，改革，效果评价 |
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| Analysis and Evaluation of the Medical Service Reform Effect of “Treatment Before Payment” Model |
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| Abstract: |
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Objective
To compare the change of the key points, such as medical service, quality, efficiency and cost changes, etc, in order to provide reference for the perfection of “treatment before payment” model. Methods Selecting 266 medical and health institutions from all levels and of all kinds as the research subject, doing questionnaire research on “Jining City ‘treatment before payment’ promotion effect evaluation questionnaire”, and doing field interview of 15 hospitals through stratified sampling. Results The rate of inpatients who were under “treatment before payment” model in Jining City reached 59.45%, with 37.29% increasing rate annually. Medical and health institutions from all levels and of all kinds allover the city implement the system, and the rate of the second level institutions and below（77.18%） was higher than the third level health institutions（63.71%）. Conclusion The reform of “treatment before payment” meet people’s medical needs. The total cost of inpatients under health insurance and NCMS is controlled rationally, and the patients’ burdens at their own expense are relieved. In order to avoid risk, resolutions of payment on account and vicious arrearage are proposed. |
| Key words: treatment before payment, medical service, reform, effect evaluation |
