公立医院医疗欠费影响因素分析及对策管理——以F医院为例  

Factors influencing medical arrears in public hospitals and countermeasures:a case study of F hospital

作　　者：罗钒玮 黄华[1] 孙飞[1] LUO Fanwei;HUANG Hua;SUN Fei(The First Affiliated Hospital of Chongqing Medical University,Chongqing 400046,China)

机构地区：[1]重庆医科大学附属第一医院,重庆400046

出　　处：《现代医院》2024年第2期267-270,共4页Modern Hospitals

摘　　要：目的进一步降低公立医院群众欠费金额,加强债权管理,提高医院整体运行效率,推动医院精细化管理,促进医院高质量发展。方法选取2019—2023年重庆某公立三甲医院3000名住院患者相关信息,其中欠费患者486名。通过单因素分析和二元logistic回归分析,研究欠费影响因素,进而提出医院欠费管理对策。结果单因素分析表明医保属性、科室、性别、年龄以及原因调查是影响欠费的相关因素(P<0.05)。二元logistic模型与观测值拟合良好,各分类因素显著性小于0.05。自费患者较医保患者欠费发生率更高;外科的欠费率最高,外科需要进行专项培训,加强欠费管理;41~60岁欠费比率最高,专管护士遇到这部分年龄段的患者时,需重点关注。欠费原因主要为:恶意逃费、纠纷欠费、三无患者欠费(绿色通道)、突发公共事件欠费、经济困难欠费。结论医院进行欠费管理时,应完善欠费管理制度,梳理各部门职责和管理流程,把控入院前到出院期间欠费管理关键控制点。Objective To reduce the amount of public hospital arrears,strengthen debt management,improve the overall operational efficiency of the hospital,promote fine management of the hospital,and boost high-quality development of the hospital.Methods We analyzed relevant data collected from 3000 inpatients,including 486 with outstanding debts,treated at a tertiary public hospital in Chongqing between 2019 and 2023.Single factor analysis and binary logistic regression analysis were performed to identify the causes of medical arrears,and subsequently propose effective debt management strategies.Results Univariate analysis revealed that factors such as medical insurance status,department,gender,age,and cause of arrears significantly influenced the occurrence of medical arrears(P<0.05).The analysis based on the binary logistic model exhibited a good fit with the observed values,with the value of each classification factor s significance less than 0.05.The incidence of arrears was higher among self-funded patients compared to those with medical insurance.The surgical department had the highest rate of arrears,necessitating specialized training for better debt management.The patients aged between 41 and 60 had the highest arrear rate,indicating the need for professionally trained nurses to pay close attention to this age group.The primary reasons for arrears included deliberate evasion,disputes,questionable sources(green passage),unforeseen public events,and economic difficulties.Conclusion To effectively manage medical arrears,hospitals should enhance their debt management systems,delineate departmental responsibilities and management processes,and implement stringent controls at key points from admission to discharge.

关 键 词：公立医院 欠费管理 影响因素 高质量发展 对策管理 

分 类 号：R197.32[医药卫生—卫生事业管理]