| 摘要: |
| 目的 了解医院在总额预付制下所采取的费用管理措施以及这些措施对医生处方行为与患者诊疗结果的具体影响。方法 采用问卷调研的方法进行实证研究，并结合专家访谈的方法进行论证讨论。结果 研究发现，总额预付制下，目前医院医保费用管理措施在控制费用的同时对临床服务质量与患者满意度产生了一些意想不到的影响。结论 总额控费带来的相关问题应引起关注，建议可从保证医疗服务质量、优化医疗费用结构和控费方法精细化三方面对控费进行完善。 |
| 关键词: 总额预付 医疗保险 医保控费 医疗服务行为 医疗质量 |
| DOI： |
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| 基金项目: |
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| Impact of Health Insurance Expense Management Measures on Medical Service Behaviors Under Total Budget Payment System |
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| Abstract: |
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Objective To understand and analyze the budget management measures taken by hospitals under total budget payment system, as well as the impact of these measures on physicians’ behavior and patients’ outcomes. Methods Questionnaire survey in combination with qualitative interview with KOLs. Results The study showed that the current budget management measures had unintended negative effects on healthcare quality and patient satisfaction, in addition to cost control. Conclusion More attention should be paid to the issues caused by total budget control. It is suggested to improve the budget control based on medical quality ensuring, optimized medical cost structure as well as refined budget control measures. |
| Key words: volume control, medical insurance, medical expense control, medical service behavior,quality assurance |
