DIP付费下医保患者住院费用结构变动分析  

Analysis on Changes of Medical Expense Structure of Basic Medical Insurance Inpatients Under DIP Payment Mode

作　　者：王德礼 窦水儿 徐益祥 孙德秋 

机构地区：[1]扬州市中医院,扬州225009

出　　处：《中国医疗保险》2024年第4期108-112,共5页China Health Insurance

基　　金：2023年扬州市卫生健康经济管理课题“DIP付费模式下医保患者住院医疗费用结构变化及优化研究”(CW202306)。

摘　　要：目的:研究DIP付费模式下住院医疗费用结构变化,为中医医院调整住院医疗费用结构,科学制定管理策略提供依据。方法:运用结构变动度分析法和灰色关联分析法,以扬州市某三级甲等中医院为例,分析2022年第一季度至2023年第三季度住院次均费用变化。结果:医保患者住院次均费用呈下降趋势,诊断费在住院费用中占比最高,其次是西药费和耗材费。诊断费与住院费用变化态势的关联度最大,其次是西药费和耗材费,中医治疗费、综合服务费、中药类费用与住院次均费用关联程度上升。结论:住院次均费用呈下降趋势;控制诊断费比例,加强合理检查监管;提升体现医务人员劳动价值的综合服务费、治疗费、中医治疗费比例。Objective:The paper studies the changes of hospitalization expense structure under DIP payment mode,to provide support for adjusting hospitalization expense structure and making scientific operation strategy in TCM hospitals.Methods:The change of average cost of hospitalization from the first quarter to the third quarter of 2022 was analyzed by degree of structure variation and grey relational analysis,taking a class A tertiary Chinese hospital in Yangzhou City as an example.Results:The average hospitalization expenses of the patients with medical insurance showed a downward trend.The diagnosis expenses accounted for the highest proportion in the hospitalization expenses,followed by the expenses of western medicine and consumables.The correlation degree between diagnosis fee and hospitalization fee was the highest,followed by western medicine fee and consumable fee,while the correlation degree between TCM treatment fee,comprehensive service fee,Chinese medicine fee and average hospitalization fee increased.Conclusion:The average hospitalization cost is showing a downward trend.We should control the proportion of diagnostic fees and strengthen reasonable inspection and supervision,increase the proportion of comprehensive service expenses,treatment expenses and TCM treatment expenses which reflect the value of medical personnel.

关 键 词：DIP付费 医保患者 住院医疗费用 结构变动 

分 类 号：F840.684[经济管理—保险] C913.7[社会学]