按平均定额付费对糖尿病足诊疗行为的干预研究  

Interactive Research of Diabetic Foot Treatment Behavior Based on Using Average Quota Payment

作　　者：徐莉[1,2] 廖新波[1,3] 赖永洪[4] 简小兵[2] 周琼 

机构地区：[1]中山大学,广东广州510130 [2]广州市中医医院,广东广州510130 [3]广东省卫生厅,广东广州510060 [4]广州医学院第三附属医院,广东广州510150 [5]广州市红会医院,广东广州510220

出　　处：《中国医院管理》2012年第6期41-43,共3页Chinese Hospital Management

摘　　要：目的了解广州市社会医疗保险"按平均定额付费"方式对医生在为糖尿病足患者诊疗时诊疗行为的干预效果。方法将广州市医疗机构按医保定额水平分为A、B两类,问卷调查A、B两类医疗机构共104名参与糖尿病足诊治的执业医师,研究不同医保定额水平下医疗机构医生行为的差异。结果A、B两类医院医生在为糖尿病足医保患者诊疗时不容易发生诱导需求行为;A类医院仅有14.6%的医生愿意收治医保糖尿病足患者;"按平均定额付费"对糖尿病足患者诊疗效果限制程度A类医院较强。结论"按平均定额付费"能够有效地约束医生诱导需求行为,降低医疗费用,但对糖尿病足疾病的治疗存在不足。Objective To know the interactive effect of using ＂average quota payment＂ in Guangzhou social medical insurance on the doctors＇ treatment of diabetic foot（DF） patients.Method According to the average quota level about Social Medical Insurance,the hospitals in Guangzhou have been divided into Class A and Class B.104 questionnaires to doctors,who have participated in the treatment of diabetic foot patients,are investigated.Results Doctors can strictly enforce the standard when they are treating the DF patients,and there are only 14.6% of doctors were willing to treat the DF patients in Class A hospitals.In Class A hospitals,the restriction level of using ＂average quota payment＂ on the treatment effect of DF patients is bigger than in Class B.Conclusion ＂Average quota payment＂ can effectively restrict the lured demand behavior of doctor and reduce the medical charge,but it has disadvantages in the treatment of DF.

关 键 词：糖尿病足 医生行为 按平均定额付费 调查 

分 类 号：R197.3[医药卫生—卫生事业管理]