| 摘要: |
|
目的
了解银川市定点医疗机构总额预付制的实施效果，在此基础上探究总额预付制下不同方式下医保基金的控制与管理。方法 采用定性分析与定量分析相结合的方法，采用SPSS软件对数据进行分析，采用病例组合方法进行改进方法研究。结果 银川市总额预付制实施后费用控制效果不明显，次均费用等指标呈现上升趋势，同时也发现实施方案中存在一些问题。结论 针对总额预付实施方案中出现的问题，提出以病例组合平均费用作为总预付方案，控制费用的同时合理利用医疗资源，促进病人合理分流。 |
| 关键词: 总额预付 效果评估 病例组合 |
| DOI： |
|
| 基金项目: |
|
| Research on the Global Budget Payment System of Medical Insurance in Ningxia Public Hospitals |
|
| () |
| Abstract: |
|
Objective
To study the effect of Yinchuan’s global budget payment system, and explore the control and management of health insurance funds under global budget payment of different modes on this basis. Methods Combining qualitative analysis and quantitative analysis methods, using SPSS software to analyze data, and using the method of case mix. Results On the overall view, the effect of the implementation of global budget payment system is not obvious, average fee shows a trend of rising, at the same time, some problems exist in the implementation plan. Conclusion In view of the problems arising from the global budget implementation plan in advance, average cost as the general plan in case mix should be proposed, the cost be controlled and the health resources be used reasonably, to promote the patient reasonable divergence. |
| Key words: global budget, effect evaluation, case mix |
