医保病人住院费用的管控  

Management and Control about the Hospitalization Expense of Medical Insurance Patient

作　　者：董一颍[1] 闫小萍[1] 彭碧波[1] 

机构地区：[1]北京市武警总医院计算机中心,100039

出　　处：《中国病案》2011年第5期7-8,共2页Chinese Medical Record

摘　　要：目的研究医疗保险病人住院医疗费用的影响因素,以控制医疗成本,降低医疗费用。方法对2005年-2009年出院97797例病人(医疗保险病人17838例)数据进行单因素方差分析和多因素逐步回归分析。结果医保就诊人群由1886例增加到4906例的同时,医保住院费用也由例均13397元上升至16870元;影响住院费用的主要因素,按其对住院费用作用的由大到小,依次为住院日、年龄、手术、收治科室、治疗效果、性别。结论建议制定标准化的规范管理缩减住院日,降低药品耗材费用减少患者就医成本,同时公开透明医疗收费建立监督机制,以促进医疗质量的提高,遏制不合理住院费用产生。Objective This paper researches the influencing factors hospitalization medical expenses of medical insurance patients,for controlling medical cost and reducing expense.Methods 97797 cases of hospitalization patients from 2005 to 2009（17838 cases of medical insurance patients） are analyzed by one-way ANOVA and multiple stepwise regression.Results Medical insurance patients increase from 1886 to 4906 cases,meanwhile the hospitalization expense also increase from 13397 RMB to 16870 RMB per case.The main factors affecting hospitalization expense,according to their effect to it,from major to minor,are respectively hospitalization day,age,operation,hospitalization department,treatment effect and gender.Conclusions This paper suggests that should set up standardization management to reduce hospitalization day,medicine consumable expense and patient＇s cost of seeing doctors.Meanwhile,medical expenses should be opened by setting up supervision mechanism,for improving medical quality and suppressing unreasonable hospitalization expense.

关 键 词：医疗保险 住院费用 影响因素 管理控制 

分 类 号：R197.3[医药卫生—卫生事业管理]