广东地区19 313例心血管外科疾病患者住院费用及医保费用分析  

ANALYSIS OF HOSPITALIZATION EXPENSES AND MEDICAL INSURANCE FOR 19 313 PATIENTS WITH CARDIOVASCULAR SURGICAL DISEASES

作　　者：徐力新[1] 李丹[1] 欧凡[1] 

机构地区：[1]广东省人民医院/广东省医学科学院,广东广州510080

出　　处：《现代医院》2015年第11期121-124,共4页Modern Hospitals

基　　金：广东省科技计划项目(编号:2012B061700056)

摘　　要：目的 为控制医疗费用、医保费用的不合理增长,为心血管外科患者医保定额的核定提供有效依据。方法 笔者通过实例分析广东地区2009~2013年19 313例心血管外科患者的住院费用及医保费用,对比医保患者与自费患者的费用结构,以及不同年龄层患者的费用结构。结果与结论 成年患者医保管控重点应在材料,分别核定医保费用定额,未成年人指定单病种应提高报销比例减轻患者负担。Objective To prevent the upsurge of health care and medical insurance costs and provide evidences for the evaluation of medical insurance quota of patients with cardiovascular surgical diseases. Methods Hospitalization expenses and health care costs of 19 313 patients with cardiovascular surgery diseases from the year of 2009 to 2013 in Guangdong province were analyzed. The comparison was done in the cost structure between patients with medical insurance and those at their own expense as well as among different age groups. Result ＆ Conclusion For adult patients, medical insurance regulator should focus on paper materials and health care costs need to be evaluated separately. For young people, reimbursement ratio for a certain appointed disease should be improved to relieve their burdens.

关 键 词：心血管外科疾病 住院费用 医保费用 疾病负担 

分 类 号：R473.6[医药卫生—护理学]