医保信用等级制度对费用转移的影响研究  

Impact Study of Medical Insurance Credit Rank System toward Medical Expense-shifting

作　　者：王鸿勇[1] 王黎勇[1] 王晓屏 彭涛 王军 

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

出　　处：《中国卫生经济》2010年第11期16-18,共3页Chinese Health Economics

摘　　要：目的:评估实行信用等级制度后,医院向非医保患者转移医疗费用负担的影响,并提出政策建议。方法:以定点医院参保和非参保患者医疗费用为指标,分析医疗费用负担的变化。结果:实施信用等级制度后,A和B等级医院自费患者住院费用增幅明显加快,参保患者医疗费用增幅明显降低,自费患者增幅高于参保患者。C信用等级医院相关指标未有显著差别。结论:实施信用等级评价制度后,较高信用等级医院存在住院费用的转移。Objective：To evaluate the influence of shift to patients expenses after implementing credit rank system,and put forward some policy suggestions.Methods：Analyzing the change of average inpatient expense between patients having medical insurance and patients having no medical insurance before and after implementation of medical insurance credit rank system.Results：After the implementation of credit rank system,hospitalization expenses of self-financed patients of A and B credit rank hospitals increase obviously,faster than the patients with medical insurance.Credit rank hospitals have no significant differences related indexes.Conclusion：After the implementation of credit rating system,hospitals with higher credit rank have shift expenses.

关 键 词：医疗保险 医院 信用等级制度 费用转移 费用控制 

分 类 号：F842.6[经济管理—保险]