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目的
分析宁夏银川市三级甲等医院职工基本医疗保险总额预付制的基本运行情况以及综合实施效果变化，为更好的实施总额预付制提供合理的建议。方法 对7家三甲医院2012年以及2013年的出院人次、次均费用、次均医保支付、非医保支付指标进行统计对比，运用秩和比法综合评价7家三甲医院总额预付制实施的效果。结果 2013年7家三甲医院一共透支了34.88%，2013年较2012年次均费用、次均医保支付、非医保支付比例均呈现增长趋势，次均医保支付增长幅度与次均费用增长幅度不成比例，而且次均医保支付增长均远远高于次均费用增长。宁夏人民医院和宁夏医科大总院心脑血管病医院的RSR值小幅度增加，其余5家三甲医院的RSR值均降低。结论 7所三甲医院透支严重，医院承担很大超支的风险和压力，对医院的正常运营会有影响。总体来看，政策没有有效的控制医疗费用的增长，总额预付制的综合运行效果不明显。增强医保中心对医院的管理，医院内部要实行“总额控制、结构调整”的管理，健全信息系统，加强监督与管理。 |
| 关键词: 总额预付制 医院 效果 |
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| Study of the Implementation of Global Budget Payment System of Medical Insurance in Yinchuan 3A-level Hospitals |
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| Abstract: |
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Objective Based on the analysis of implementation of global budget payment system of medical insurance of 3A-level Hospitals. to provide a better reference. Methods Collected the date that include average fee per discharge, average admission per month and so on. the analysis used the the RSR method. Results a total of seven 3A-level Hospitals had overdrawn34.88%, Overall, compared with 2012, the payment proportion of the fee per time、the fee with medical insurance per time and the fee without medical insurance trend to increase, the growth of the fee with medical insurance and the fee per time increased disproportionately, the fee with medical insurance per time are paid far more than the fee per time. Conclusion The RSR model indicated that some indexes not improved remarkably after the GB was implemented．the cost control effect is not obvious. The scientific measurement of medical insurance fund of health care center for health care institutions should be strengthened，the management of health care center for hospital be enhanced，and the information system be improved，and supervision and management be strengthened. |
| Key words: global budget,hospitals, effect |
