军队医院医保考评体系效果评价  

Evaluation of Medical Insurance Evaluation System in Military Hospital

作　　者：夏丽真[1] 张茜[2] 

机构地区：[1]海军总医院医保办,北京100048 [2]海军总医院,北京100048

出　　处：《中国卫生质量管理》2016年第1期43-45,共3页Chinese Health Quality Management

摘　　要：目的探讨军队医院医保考评体系的效果及存在问题。方法应用倍差法比较干预组和对照组的主要住院指标变化情况。结果在出院人数大幅增长的同时,干预组次均费用总体呈下降趋势,平均住院日有所缩短,药费比、自付比明显下降。结论军队医院实行医保考评体系初见成效,应科学合理确定医保考核指标,落实考核结果奖惩情况,重视医保考评效果评价,建立医保考评体系管理的长效机制等。Objective To investigate the effect and problems of the medical insurance evaluation system in military hospital. Method The double difference method was used to compare the main hospital index between the intervention group and the control group. Result With a large increase in the number of discharged patients, the intervention group showed an overall decreasing trend of the average cost, with shortened average length of stay, lower proposition of medication fees and self - pay ratio. Conclusion The medical insurance evaluation system in military hospital showed preliminary effect. The assessment indicators should be reasonably and scientifically determined, reward and punishment on evaluation results should be applied, evaluation on effect needs to be paid attention to and the long - term mechanism of medical insurance evaluation system management needs to be established.

关 键 词：医保考评体系 总额预付 效果评价 倍差法 

分 类 号：R192.3[医药卫生—卫生事业管理]