医保费用不合理增长的调查与分析  

Investigation and Analysis of Unreasonable Growth about Medical Insurance Costs

作　　者：李愉[1] 雷敏[1] 褚晓静[1] 姜新莉[1] 

机构地区：[1]解放军第一七四医院医保办,厦门 361003

出　　处：《中国病案》2015年第4期50-52,共3页Chinese Medical Record

摘　　要：目的分析医保费用增长过快的原因,探讨如何控制医保费用不合理增长。方法提取2011年-2012年度医保出院患者数据进行对比分析实施"医保大额病例管理制度"费用控制情况。结果 2012年度在医保出院人数增长为22.66%的情况下,大额出院人数增长率为12.83%。出院均费增长率为2.37%,相比2011年度16.13%的增长率降低了13.76%。结论实施"医保大额病例管理制度"后,医院医保大额费用出院人数增长得以控制,医保出院均费几乎零增长,医院医保出院费用不合理增长得到较好的控制。Objective To analyze the causes of the rapid growth of medical insurance costs, and discuss how to control unreasonable growth. Methods We extracted data of medical insurance patients from 2011 to 2012 and analyzed the cost control o‘fmedical insurance large denomination medical record management system＇. Results In the case of population growth of medical insurance patients was 22.66%,the rate of population growth of large denomination discharged patients was 12.83%. Discharge average costs growth rate was 2.37%; compared with 2011 the growth rate was reduced from 16.13% to 16.13%.Conclusion population growth of large denomination discharged patients was controlled after implement of‘medical insurance large denomination medical record management system＇.Medical insurance discharge average costs were almost zero growth. Unreasonable growth about medical insurance costs had been controlled.

关 键 词：病历管理 医保费用 大额病历? 

分 类 号：R197.3[医药卫生—卫生事业管理]