不同医保患者住院费用比较研究  

Conparison of Hospital Expense among Patients with Different Medical Insurances

作　　者：王庆宏[1] 毛瑛[2] 田玉兔[2] 杨昌国[2] 汪浩[2] 李哲[1] 

机构地区：[1]第四军医大学西京医院,陕西西安710049 [2]西安交通大学,陕西西安710049

出　　处：《中国卫生质量管理》2010年第4期24-27,共4页Chinese Health Quality Management

基　　金：国家自然科学基金(70873093)

摘　　要：目的比较不同医保患者(包括自费患者)住院费用的差别以及住院费用的影响因素,为医疗保险管理部门控制住院费用不合理增长提供政策建议。方法从某三甲综合性医院医保管理系统获取住院费用数据,运用方差分析比较不同医保患者住院费用及各部分费用间的差异,运用卡方分析比较不同医保类型患者特殊检查、特殊治疗的利用率等。运用线性回归方法,分析住院费用的影响因素。结果不同医保患者住院费用、住院费用构成、特殊检查和特殊治疗利用率存在显著差异,住院费用受患者本身和医院两方面因素的共同影响。结论 "新农合"管理部门应加强省级定点医疗机构的监管以控制住院费用的不合理增长。各类医保部门均应从控制病人住院天数、药品费用、重点人群监控等方面控制住院费用的增长。Objective To aompare hospital expense among patients with different medical insurances, to analyze factors on hospital expense and provide suggestions for medical insrance policy. Method We got data from one general hospital, used ardysis of variance to compare the difference of the hospital expenses among patients with different medical insurances, used chisquare test to analyze the differeee of special examinations and treatments, used linaer linear regression to explore the factors on hospitalization expense. Result There were significant differences among the hospital expenses of patients with different medical insurances. The hospital expense was affected both by the patient side and the hospital side. Conclusion The NRCMS management should strengthen the supervision of designated medical institutions to control the growth of unreasonable hospital costs. In addition, various types of health insurance sectors should strengthen the control of hospital duration, drag costs, and the monitoring of key population to control the growth of hospital costs.

关 键 词：职工医保 居民医保 新农合 

分 类 号：R197.322[医药卫生—卫生事业管理]