医保信用等级制度对医院的经济约束分析  

Analysis of Medical Insurance Credit Rank System Effect toward Hospitals' Economy Restriction

作　　者：王鸿勇[1] 王黎勇[1] 王军 王晓屏 彭涛 崔爱庆[3] 

机构地区：[1]山东省潍坊市卫生局,山东潍坊261061 [2]山东省临沂市医疗保险事业处,山东临沂276000 [3]山东大学齐鲁医院,济南250012

出　　处：《中国卫生经济》2010年第11期14-15,共2页Chinese Health Economics

摘　　要：目的:研究实施医疗保险信用等级制度对医院经营行为的规范及约束作用。方法:以定点医院经济和工作量为指标,建立ARMA模型,比较该制度实施前后医疗保险管理机构对定点医院经济约束作用的变化。结果:A信用等级医院的经济收入和工作量指标均明显增长,B和C信用等级医院相关指标出现下降,C等级医院降幅最大。结论:实施信用等级评价制度对医院经济收入和工作量均有显著影响,对医院有较强的经济约束作用。Objective：To study the implementation of medical insurance credit rank system for hospital management behavior of norms and constraint function.Methods：Establishing the ARMA model and comparing change of the system concerning contracted hospitals＇ economy restriction effect before and after implementation of the system.Results：A credit rating of the economic income and hospital workload indexes increases obviously,B and C credit grade hospitals related indexes begin to decline,C grade hospitals drop mostly.Conclusion：The Implementation of medical insurance credit rank system for evaluation of economic income and workload hospital influence hospitals significantly,and have stronger economic constraints.

关 键 词：医疗保险 信用等级制度 医院 经济约束 费用控制 

分 类 号：R197.3[医药卫生—卫生事业管理] F842.6[医药卫生—公共卫生与预防医学]