国家谈判药品对综合医院医保管理的影响及对策  

Impact of National Negotiation Drugs on Medical Insurance Management in General Hospitals and Countermeasures

作　　者：梁冰[1] 王前强[2] 陈凤磊 宾能海 LIANG Bing;WANG Qian-qiang;CHEN Feng-lei;BIN Neng-hai(The First Affiliated Hospital of Guangxi Medical University,Nanning Guangxi 530021,China;不详)

机构地区：[1]广西医科大学第一附属医院,广西南宁530021 [2]广西医科大学,广西南宁530021

出　　处：《卫生经济研究》2020年第5期42-44,49,共4页

基　　金：国家社会科学基金项目“十八大以来医药领域反腐败政策降低制度性交易成本的效应研究”(18XZZ013)。

摘　　要：利用广西自治区南宁市某三甲医院信息管理系统,提取该医院2017年和2018年统筹区内医保患者数据,分析国家谈判药品使用对医院医保管理的影响。结果显示,国家谈判药品的使用提高了医保住院次均费用、人次人头比、药占比等。对此,应完善对该类药品的管理,提高医院医保管理质量,切实保障患者的医保待遇。Utilizing the information management system of a IIIA hospital in Nanning,Guangxi Autonomous Region,the data of the hospital’s medical insurance patients in 2017 and 2018 were extracted,and the impact of the negotiated drug use on the hospital’s medical insurance management was analyzed. The results show that the use of drugs negotiated by the state has increased the average cost of medical insurance hospitalizations,headcount per person,and drug ratio. In this regard,the management of such drugs should be improved,the quality of medical insurance management in hospitals should be improved,and the medical insurance treatment of patients should be effectively guaranteed.

关 键 词：医保管理 国家谈判药品 医保支付 

分 类 号：R19[医药卫生—卫生事业管理]