总额预付制实施效果及院内控费措施研究  

Study on the Implementation Effect of the Total Prepayment System and the In-house Fee Control Measures

作　　者：周杰华[1] 孔旭辉[1] 黄秀芹[1] ZHOU Jie-hua;KONG Xu-hui;HUANG Xiu-qin(Jiangsu Province Taizhou People's Hospital,Taizhou Jiangsu 225300,China)

机构地区：[1]江苏省泰州市人民医院

出　　处：《卫生经济研究》2019年第11期46-48,共3页

基　　金：江苏省医院协会医院管理创新重点项目(JSYGY-2-2017-88);泰州市软科学研究计划项目(RKX201821)

摘　　要：某医院实施总额预付制以来,总额预付指标额使用率不断提高并回归合理,总额预付对医疗费用控制和费用结构调整具有积极效果,次均住院费用、药占比有所下降;总额预付患者的获益人数逐年增多,报销比例稳步提升,且高于其他医保患者报销比例。可见,总额预付制平稳运行,初步实现了制度设计的预期目标。Since the implementation of the total prepayment system in X hospital,the usage rate of the total amount of prepaid indicators has been continuously improved and returned to a reasonable level. The total advance payment has a positive effect on the control of medical expenses and the adjustment of the cost structure. The average hospitalization expenses and the proportion of medicines have decreased. The number of people benefiting has increased year by year,and the proportion of reimbursement has steadily increased,which is higher than the reimbursement rate of other medical insurance patients. It can be seen that the total prepayment system operates smoothly and initially realizes the expected goals of the system design.

关 键 词：总额预付制 医保费用 控费措施 

分 类 号：R19[医药卫生—卫生事业管理]