乌鲁木齐市某所三级甲等医院1092例高血压病医保患者住院费用的分析  

A study on medical expense of 1 092 insured inpatients with primary hypertension in one grade-three hospital in Urumqi

作　　者：方娴[1] 买买提.牙森[2] 姚萱[1] 

机构地区：[1]新疆医科大学公共卫生学院社会医学教研室,新疆乌鲁木齐830011 [2]新疆医科大学,新疆乌鲁木齐830011

出　　处：《新疆医科大学学报》2008年第5期608-610,共3页Journal of Xinjiang Medical University

摘　　要：目的：探讨高血压病住院医保患者医疗费用增长情况，为建立合理的医疗费用控制机制提供依据。方法：对乌鲁木齐市某所三级综合型医院2003年1月～2007年9月收治的1092例高血压住院医保病例的住院天数、住院费用以及个人支付和统筹支付费用情况进行分析。结果：5年来次均住院天数的平均增长速度为2．86％，次均住院费用的平均增长速度为6．45％，次均床位费用、药品费用、检查费用、诊疗费用的平均增长速度分别为5．22％、-3．92％、11．18％、25．41％，个人支付费用占住院总费用的比例由2003年的54．21％下降至2007年的38．01％，降幅明显。结论：控制药费、检查费用和诊疗费用等费用增长点，继续发挥城镇职工基本医疗保险的作用，倡导慢性疾病的管理以及发挥社区医疗服务机构的功能是控制医疗费用增长的有效途径。Objective： To discuss medical expense growth situation about insured inpatient with primary hy- pertension, and provide the basis to found the reasonable medical expense control mechanism. Methods： Number of days in hospital, medical expense, individual payment and fund payment of 1092 insured inpa- tient with primary hypertension who is in the certain grade-three hospital in Urumqi, from January, 2003 to September, 2007 has carried on analysis. Results： In 5 years, the average rate of growth of the number of days in hospital per person was 2.86~, average rate of growth of the medical expense per person has 6.45~/oo, even the bed expense, the drugs expense, the inspection expense, the diagnosing and treating expense＇s average rate of growth were 5.22%, --3.92%, 11.18%0, 25.41% respectively, the proportion of individual payment reduced from 54.21% to38.01% by 2003 to 2007, the range of fall was obvious. Conclusions： Control drugs, check up,diagnosing and treating expenses increase in the cost clinics, continue to play the role of basic medical insurance system for town staff , propose the management of chronic diseases, and play the function of the community medical service agencies are effective ways to control the growth of medical expenses.

关 键 词：城镇职工基本医疗保险 住院费用 个人支付 统筹支付 

分 类 号：R544.1[医药卫生—心血管疾病] R197.1[医药卫生—内科学]