海医保政策实施对三级医院的潜在影响分析  

Potential Influences of Implementation of the Medical Insurance on the Tertiary Hospitals in Shanghai.

作　　者：王丽红[1] 章滨云[1] 孙斌[1] 邹晓静[1] 陈缨[1] 

机构地区：[1]复旦大学医院管理处,上海200032

出　　处：《中国卫生事业管理》2002年第4期215-217,共3页Chinese Health Service Management

摘　　要：文章以 7所三级医院为研究对象 ,分析了上海市全面实施城镇职工基本医疗保险制度对医院所产生的初步影响 ,显示在放开医保定点医院引入竞争机制后 ,专科医院医疗工作量明显上升 ,较综合性医院有明显的市场竞争优势。分析也显示 ,在统帐结合的新医保政策下 ,三级医院医疗费用的增长主要是指门急诊费用的增长 。Regarding seven tertiary hospitals as the objective, this paper analyzes the influences of comprehensively implementing the urban employee basic medical insurance on hospitals. It shows that the quantity of medical service in special hospitals is rising after opening contracted hospital and introducing the competitive mechanism. The special hospitals have more advantages in the market than general hospitals. It also shows that the main contributions to increase of medical expense are outpatient visits and emergency under the new policy of combination of individual account and pool, which suggests that the individual account management should be perfected.

关 键 词：医疗保险 医疗工作量 医疗费用 三级医院 上海 

分 类 号：R197.3[医药卫生—卫生事业管理]