吉林省某三级甲等医院老年医保患者住院费用及病种情况分析  

Analysis of hospitalization expenses and diseases of elderly medical insurance patients in a tertiary hospital in Jilin Province

作　　者：陈微[1] 郑希彤 陈广宇 苏馨 王建国[1] CHEN Wei;ZHENG Xi-tong;CHEN Guan-yu(Medical insurance office of the first hospital of Jilin University,Changchun 130021,China)

机构地区：[1]吉林大学第一医院医保办,吉林长春130021

出　　处：《吉林医学》2021年第11期2811-2814,共4页Jilin Medical Journal

摘　　要：目的:分析吉林省某三甲医院60岁以上老年医保患者的住院费用、报销比例、住院天数等指标,为完善老年患者的医保政策提供参考性建议。方法:调取长春市某三甲综合医院2017年~2019年60岁以上老年患者的住院数据,将离休人员、保健对象、普通退休职工及城乡居民医保患者作为研究对象,进行描述性分析。结果:老年医保患者的住院人次、次均费用均有所提高,2019年的增长趋势尤为显著,住院人次上升15.32%,次均费用上升12.09%;不同人员类别的患者报销比例差异较大,离休人员、保健对象明显高于普通职工和城乡居民医保患者。结论:加强对老年医保患者住院费用的监管,建立专门的医保制度,提高待遇公平性;加强慢性病管理,提高老年患者对慢性病的预防和治疗意识。Objective To analyze the inpatient cost of medicare patients over 60 years old in a grade A hospital in Jilin Province,reimbursement ratio,indicators such as length of stay in hospital,to provide reference suggestions for improving medical insurance policies for elderly patients.Method The inpatient data of elderly patients over 60 years old from 2017 to 2019 were collected from a third-grade A general hospital in Changchun city,retired personnel,health care targets,ordinary retired employees and urban and rural residents with medical insurance as the research objects,perform descriptive analysis.Results The number of hospitalizations and the average cost of hospitalization for elderly medical insurance patients had increased,the growth trend in 2019 was particularly significant,number of hospitalizations increased by 15.32%,average cost per time increased by 12.09%;The reimbursement ratios of patients in different categories were quite different,retired personnel,health care objects were significantly higher than ordinary workers and urban and rural residents of medical insurance patients.Conclusion We will strengthen oversight of hospitalization costs for medicare patients,establish a special medical insurance system,improve fairness in treatment;strengthen the management of chronic diseases,to raise the awareness of prevention and treatment of chronic diseases in elderly patients.

关 键 词：三级甲等医院 老年人医保 住院费用 住院病种 

分 类 号：R197.32[医药卫生—卫生事业管理]