医保总额预付制对上海市三级医院医疗收入结构的影响分析  

Research on the effect of global budgeting in the structure of medical income towards the tertiary hospitals in Shanghai

作　　者：黄玲萍 王锦福 于广军[2] 杨中浩 杨丽 厉传琳 王永芝 

机构地区：[1]上海申康医院发展中心,上海市静安区康定路2号200041 [2]上海市儿童医院

出　　处：《中国医院》2013年第9期10-12,共3页Chinese Hospitals

基　　金：IMS中国医疗健康信息学院"卫生服务研究网络"资助项目;2012年度上海市卫生局局级科研项目"上海市实施医保总额预付制对三级医院的影响评估"(20124422)

摘　　要：研究2008-2011年上海部分市级公立医院相关经济数据,发现实施医保总额预付后,试点医院医疗收入结构有显著变化,医疗收入结构中自费比重出现普遍上升,且门诊及住院收入结构中自费比重上升的形成原因有所差异。预付制试点医院的医疗收入结构变化以及药费控制效果等较非试点医院较为明显,重要影响因素是总额预算向总额预付的制度改进强化了医院管理者对医保控费的政策预期。This paper gives an analysis of the economic data of shanghai municipal public hospital from 2008 to 2011. The finding is that the structure of hospital’s medical income has changed and the patient self-payment proportion of health expenditure in hospital has risen universally, after the implementation of global budget and prepayment pilot. The formation mechanism of medical income structure’s changes between outpatient section and inpatient section is different. The changes of medical income structure and the effect of drug expenditure control have be more obvious for pilot hospital than non-pilot hospital, and the main reason is that the system reformation from total budget to prepayment has strengthened policy expectations of health expenditure control to hospital managers.

关 键 词：医疗保险 总额预付 三级医院 医疗收入结构 

分 类 号：R197.322[医药卫生—卫生事业管理]