目的探讨以单病种为单位的医疗费用结算,以及以病种为单位的费用预付制度。方法通过病案首页管理系统对病种的病案首页内容,对纳入研究的731例患者,采用随机分组,并根据病情轻重、有无合并症等将患者分为A、B组两组,病情轻的分到A组,病情重的分到B组。通过核定标准成本、变动成本和固定成本,以及对单病种成本差异的比较与说明,来评价其成本项目的控制效果。结果通过对2014年-2015年单病种实际成本与标准病种成本的比较,药品消耗差异为286元,而药品成本降低了32%;辅诊检查项目差异为338元,辅诊检查成本则降低了2%,两项差异比较均有统计学意义。结论研究病种医疗成本、进行单病种医疗费用核算,可以有效降低单病种医疗费用,有利于医院可持续发展。 Objective To explore the settlement of medical expenses on the basis of single disease type and the system of pre-payment for the fee of disease. Methods A total of 731 patients were included in the first page of the medical record through the case management system. The patients were randomly divided into groups A and B according to their severity and comorbidity. The patients were in mild condition Divided into A group, the disease was assigned to the B group. Through the control of standard costs, variable costs and fixed costs, as well as the comparison and description of differences in the cost of single disease, to evaluate the control effect of the cost of the project. Results By comparing the actual cost of single disease and standard disease in 2014-2015, the difference of drug consumption was 286 yuan while the cost of medicine was reduced by 32%. The discrepancy of auxiliary examination was 338 yuan and the cost of auxiliary examination was Decreased by 2%, the two differences were statistically significant. Conclusion The study of the medical costs of the disease, medical expenses for single-disease accounting, can effectively reduce the single disease medical costs, is conducive to the sustainable development of the hospital.