论文部分内容阅读
目的:评价南通市总额预付制下的结算办法的运行效果。方法:从供需双方的视角,分析不同结算方式对年人均住院次数、次均住院费用、次均医保支付及个人自付比,并建立回归模型评价运行效果。结果:患者年住院两次以上人数逐年增加,三级医院的住院费用年均增长高于二级医院,多因素回归结果发现:增幅管理模式2有效地促进医疗机构降低次均住院费用及次均医保支付费用,尤其是二级医院;次均个人自付支付比例下降了2.48个百分点。结论:医保管理部门应建立总额预付下的价格谈判机制,探索综合支付方式改革。
Objective: To evaluate the effect of the settlement method under NTA total prepayment system. Methods: From the perspective of both supply and demand, the annual per capita hospitalization, per capita hospitalization cost, per capita medical insurance payment and personal overdue ratio of different settlement methods were analyzed, and the regression model was established to evaluate the operating effect. Results: The number of hospitalized patients more than twice a year increased year by year, the average annual growth rate of tertiary hospitals was higher than that of secondary hospitals. The regression results showed that the increase management mode 2 effectively promoted the medical institutions to reduce the average cost of hospitalization and the average Medicare pay, especially in the second-class hospitals; average personal pays the proportion of down 2.48 percentage points. Conclusion: The medical insurance management department should establish a price negotiation mechanism under the total prepayment and explore the reform of comprehensive payment methods.