青光眼住院患者单病种结算费用影响因素分析  

Analysis of influencing factors for single-disease payment of glaucoma inpatients

作　　者：刘聪[1] 唐忻[2] 曾多[1] 

机构地区：[1]首都医科大学附属北京同仁医院医疗保险办公室,北京100730 [2]首都医科大学附属北京同仁医院眼科,北京100730

出　　处：《中华医院管理杂志》2014年第2期114-117,共4页Chinese Journal of Hospital Administration

摘　　要：目的 了解青光眼住院患者医保单病种结算费用的影响因素.方法 对2012年12月至2013年5月的187例青光眼医疗保险单病种结算患者进行分析,统计各项费用及其对医院及个人的影响.结果 医院收益随材料费、医事服务费、西药费、床位费、护理费、检查费、麻醉费、手术费、住院天数、个人支付等的增加而减少,随特殊治疗费的增加而增加;个人支付随人工器官、手术费、材料费等的增加而增加,随特殊治疗费、护理费、医事服务费的增加而减少.187例患者中,有64例患者给医院带来了负收益,其中每例患者的医院收益在-4 364.56～-37.53元之间.结论 医院收益与医保政策及医院效率等因素密切相关,个人现金支付与医保政策等因素密切相关.Objective To identify the influencing factors for single-disease payment of glaucoma inpatients covered by the medical insurance.Methods Analysis of 187 glaucoma inpatients of single-disease payment covered by medical insurance ranging between November 2012 and May 2013,and calculation of the expenses and the influences on both the hospital and individuals involved.Results Hospital income was found to decrease with the rise of such costs as medical materials,medical services,medicines,beds,nursing,laboratory tests,anesthesia,surgery,days of stay and out-of-pocket payment,while increasing with rise of special treatments.Individual payments increases with prices of artificial organs,surgery and medical materials,while decreasing with prices of special treatments,nursing,and medical services.Of the 187 inpatients,64 caused negative income for the hospital,with hospital incomes ranging between-4 364.56～-37.53 yuan per such inpatients.Conclusion Hospital incomes are closely related to such factors as medical insurance policy and hospital efficiency,while out-of-pocket payment is closely related to medical insurance policy.

关 键 词：青光眼 住院 单病种 结算 影响因素 

分 类 号：R775[医药卫生—眼科] R197.3[医药卫生—临床医学]