不同级别医院城乡参保和参合居民患者住院医疗费用的对比研究  

A comparative study of the hospitalization medical costs in different level hospitals for patients with urban resident medical insurance and new rural cooperative medical care

作　　者：肖倩[1] 武晓猛[1] 张龙[2] 闫子海[2] 计阿丹 肖永红 

机构地区：[1]河北联合大学冀唐学院,河北唐山063300 [2]河北联合大学公共卫生学院,河北唐山063300 [3]河北省滦县基本医疗保险中心,河北滦县063700

出　　处：《现代预防医学》2014年第17期3147-3149,3160,共4页Modern Preventive Medicine

基　　金：河北省社会科学基金项目(HB13SH027);2012年河北省社会科学发展研究课题

摘　　要：目的比较不同级别医院参加城镇居民医疗保险（简称＂参保＂）和新型农村合作医疗（简称＂参合＂）的居民患者住院医疗费用及不同支付方式费用差别,了解城乡居民医疗保障水平。方法选择某县2011年度城乡参保和参合居民患者,运用非参秩和检验分析住院医疗费用及不同支付方式费用。结果除一般检查费外,县级医院总费用、各项费用及不同支付费用均高于乡镇医院（P〈0.05）;县级医院参合与参保患者平均住院费用未见有显著差异（P〉0.05）,但参保患者统筹支付费用高于参合患者,个人支付费用低于参合患者（P〈0.05）;参保及参合居民患者乡镇医院统筹支付费用及个人支付费用均低于县级医院（P〈0.05）,但参保居民不同级别医院间统筹支付费用（63%～64%）及个人支付费用（35%～36%）所占比例接近,参合居民个人支付费用县级医院（1 647.47元）占总费用的55.84%,乡镇医院（560.81元）占43.01%。结论促进和引导参合和参保居民患者在基层医疗机构就医、合理控制药物使用、不断提高统筹支付报销比例,以减轻城乡居民疾病经济负担。Objective To compare the hospitalization medical costs and the different payment costs for patients with urban resident medical insurance and new rural cooperative medical care in different level hospitals, and know the level of medical security for urban and rural residents. Methods The hospitalized patients of the urban resident medical insurance and new rural cooperative medical care were chosen during 2011 year in a county, nonparametric rank sum test was used to analyze the inpatient＇s medical expenses and different payment costs. Results In addition to the general inspection fee, the total cost, each item expense and different payment costs in county hospitals were higher than those in township hospitals（P〈0.05）; there was no significant difference at the average hospitalization expenses between the urban resident medical insurance and new rural cooperative medical care in county hospital（P〉0.05）, the fund payments of the urban resident medical insurance was higher than that of new rural cooperative medical care, while the individual payment of the urban resident medical insurance was lower than that of new rural cooperative medical care（P〈0.05）; the fund payment and individual payment expenses for urban resident medical insurance and new rural cooperative medical care in township hospitals were lower than in the county hospital（P〈0.05）, while the proportion of the fund payment（63%-64%）and individual payment cost（35%-36%） for urban resident medical insurance were nearly in different grade hospitals, the individual payment of the total cost for new rural cooperative medical care residents accounted for 55.84% in county hospitals（1 647.47 yuan）and 43.01% in the township hospitals（560.81 Yuan）. Conclusion Patients of urban resident medical insurance and new rural cooperative medical care are promoted and guided to go the primary health care institutions for medical treatment, the drug use is controlled reasonably, and the fund payment reimbursement proportion is improv

关 键 词：不同级别医院 城镇居民医疗保险 新型农村合作医疗 住院医疗费用 支付方式 

分 类 号：R194[医药卫生—卫生事业管理]