| 引用本文: |
王震,吴聪,韩雪梅,等.甘肃省新型农村合作医疗住院患者流向及费用分析[J].中国卫生经济,2017,(2):33-35.[点击复制] |
.Analysis of the Inpatient Flow and Hospital Cost Among New Rural Cooperative Medical System in Gansu Province.[J].CHINESE HEALTH ECONOMICS,2017,(2):33-35.[点击复制] |
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| 摘要: |
| 摘要 目的：对甘肃省2010-2015年新农合住院率、患者流向、费用负担等进行分析，探讨住院费用过快上涨的原因，发现新农合制度存在的问题，为政策优化提供建议。方法: 从省新型农村合作医疗管理中心及华东公司提取2010-2015年新农合住院相关数据以及年度报表，运用卡方分析方法分析不同年度住院率、住院患者分流方面的变化，采用描述性分析方法分析住院费用、补偿费用及补偿比等方面的变化。结果:2010-2015年新农合住院率由6.37%提高到11.85%（χ2=503005.45，P=0.000）；住院人次分流方面，县级医疗机构病人增长最快，由41.05%提高到52.08%；乡级医疗机构人员出现流失倾向，由37.88%下降到25.30%；流向县外医疗机构病人明显，但所占比例变化不大仅提高了1.56%。（总体χ2=103245.25，P=0.000，两两比较P值均小于0.05）。2010-2015年住院费用增长较快且各级医疗机构分布不均衡，县外医疗机构住院费用所占比例平均为58%，县级平均为34.47%，乡级最少平均为7.53%。次均补偿费用与补偿级别成正比，2010-2015年县外医疗机构次均补偿费用由3051.42元提高到6217.40元，县级由1486.09元提高到2235.28元，乡级由611.42元提高到875.86元。实际补偿比与补偿级别成反比，乡级、县级、县外医疗机构平均补偿比例分别79.25%、66.30%和49.52%。患者就医流向不合理，补偿人次和补偿费用主要流向县及县外医疗机构，基层住院人数有流失倾向；县外医疗机构费用增长迅速，占用大量补偿资金。结论：甘肃省新农合在住院服务利用、补偿费用不断提高等方面取得一定成效的同时，应遏制医疗费用过快增长，不断提高补偿水平，合理引导患者就医流向。 |
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| Analysis of the Inpatient Flow and Hospital Cost Among New Rural Cooperative Medical System in Gansu Province. |
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| Abstract: |
| Abstract Objective: To analyze of hospitalization rates, patient flow, cost burden from 2010 to 2015 in Gansu , exploring the causes of hospitalization costs rising quickly, finding NRCM’s problems, and providing Suggestions for policy optimization. Methods: Collecting data and annual reports about the NRCM operating status from NRCM management office and Huadong company in 2010 to 2015, analyzing the different in hospitalization rates, patient flow with Chi -square Test and analyzing hospital fees, reimbursement fees and reimbursement rate with descriptive analysis. Results: The hospitalization rates of NRCM from 6.37% to 11.85%（χ2=503005.45，P=0.000）,the flow of patients fastest growing at county medical institutions from 41.05% to 52.08%, township medical institutions personnel loss, from 37.88% to 25.30% , the patients of outside the county growth significantly, but the proportion only increased by 1.56%.(Overall χ2=103245.25，P=0.000). Hospitalization expenses grew rapidly in 2010-2015 and uneven distribution of medical institutions at all levels, and the average proportion of outside the county is 58%, the county level is 34.47% and township is 7.53%.The average reimbursement fees is proportional to the level of compensation, the average reimbursement fees of outside the county from 3051.42 yuan to 6217.40 yuan, the county level from 1486.09 to 2235.28 and the township from 611.42 to 875.86. The actual reimbursement rate is opposite to the level of compensation, the average compensation ratio of township, county, and outside is 79.25%, 66.30% and 79.25% respectively. The inpatient flow is unreasonable, the number and fees of reimbursement mainly flow to the county and outside the county , hospital admissions of grass-roots have tended to lose; The cost of outside the county growth rapidly and occupy a lot of compensation funds. Conclusion: The NRCM should curb excessive growth of medical treatment charge , improve the level of compensation, and guide reasonable flow when obtaining certain achievements. |
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