县级公立医院改革对住院费用及医保基金支出影响分析  

Impact study of county-level public hospital reform on the expenditure of medical insurance fund

作　　者：许建强[1] 郑娟[1] 李佳佳[1] 徐凌忠[1] 刘芳[1] 王亨[1] 

机构地区：[1]山东大学公共卫生学院,济南250012

出　　处：《中华医院管理杂志》2016年第4期259-262,共4页Chinese Journal of Hospital Administration

基　　金：国家自然科学基金青年项目（71303137）

摘　　要：目的分析县级公立医院综合改革对住院费用及医保基金支出的影响。方法运用双重差分模型，分析某省2所县级公立医院住院费用及医保基金支出差异。结果实施县级公立医院改革后，住院患者次均药品费用、次均检查费用有所降低，分别减少318．5元、410．2元；但次均治疗费用却增加了535．6元。改革后，医保基金支出增幅变化不显著；不同医保类型对患者住院费用及医保基金支出影响差异较大。结论县级公立医院改革在降低住院患者药费、检查费方面初见成效，但要防范治疗费用的“平移增加”；确保医保基金安全需要深入改革支付方式，去除医保制度的差异化，发挥各类医疗保险对医疗服务行为及费用的调控作用。Objective To learn the impact of county-level public hospital reform on the expenditure of medical insurance fund. Methods Using the difference-in-differences model to analyze the differences incurred in both hospitalization expenditure and expenditure of the fund at two county-level public hospitals. Results The reform has reduced both the drug expenditure and examination expenses per hospitalization at such hospitals at 318. 5 yuan and 410. 2 yuan respectively, yet with an increase of treatment expenditure of 535.6 yuan per hospitalization. No significant growth rate was incurred by the reform to the medical insurance fund. A significant difference of both hospitalization expenditure of patients and the fund was found among patients covered by different medical insurance funds. Conclusions The reform has achieved initial success at such hospitals in reducing inpatients＇ drug and examination expenditures. However, it is important to prevent from the treatment expenditure from an ＂ offset increase＂ ; to further reform the payment modes for safety of the fund, to remove the differentiation found in the existing medical insurance system, and leverage the regulating role of various medical insurance funds on medical service behaviors and expenditures.

关 键 词：县级公立医院 住院费用 医保基金 影响 

分 类 号：R197.322[医药卫生—卫生事业管理]