临床路径改革对医保患者住院费用影响的ITS分析——以某三甲医院为例  

ITS Analysis on the Effect of Clinical Pathway Reform on Medical Expenses of Inpatients--Taking a Public Hospital of Grade Three as an Example

作　　者：卢秀芳 陈明明 吴银飞 王娟娟[2] 

机构地区：[1]山东大学齐鲁医院,青岛266035 [2]青岛大学附属医院,青岛266003

出　　处：《中国医疗保险》2022年第12期87-91,共5页China Health Insurance

摘　　要：目的:探讨临床路径改革对医保住院患者医疗费用及个人负担的影响。方法:选取脑梗死、脑出血、短暂性脑缺血发作及慢性阻塞性肺疾病作为临床路径实施病种,分析2019年-2021年山东省某三甲医院医保住院患者的相关数据,采用间断时间序列分析法(ITS)分析临床路径改革对患者次均住院费用、药占比、患者个人自负费用的影响。结果:医院实施临床路径改革后患者次均住院费用、药占比呈下降趋势(P<0.05);患者个人自负费用呈先上升后下降趋势(P<0.05)。结论:实施临床路径改革对医院控制医疗费用的不合理增长具有积极作用。Objective:The paper explores the influence of clinical pathway reform on medical expenses and individual burden of medical insurance inpatients.Methods:Cerebral infarction,cerebral hemorrhage,transient ischemic attack and chronic obstructive pulmonary disease were selected as clinical pathway implementation diseases in a Class A hospital in Shandong Province.Relevant data of medical insurance inpatients from 2019 to 2021 were analyzed and interrupted time series analysis(ITS)was used to analyze the effects of clinical pathway reform on average inpatient cost per time,drug proportion and patient self-expense.Results:After the implementation of clinical pathway reform,the average hospitalization cost per time and drug proportion of patients showed a downward trend(P<0.05).The self expenses increased first and then decreased(P<0.05).Conclusion:The implementation of clinical pathway reform has a positive effect on controlling the unreasonable growth of medical cost.

关 键 词：临床路径 公立医院 医疗费用 

分 类 号：F840.684[经济管理—保险] C913.7[社会学]