| 引用本文: |
纪京平,张乐辉,郭默宁,等.医保综合支付方式改革引导医疗行为改变的实证分析[J].中国卫生经济,2017,(5):56-58.[点击复制] |
.Evidence Analysis On The Effects of Combined Insurance Payment System Reform And It’s Guiding Influences To Medical Services[J].CHINESE HEALTH ECONOMICS,2017,(5):56-58.[点击复制] |
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| 摘要: |
| 摘 要：目的：对比平谷区新农合相关指标，评估平谷区新农合综合支付方式改革引导医疗行为改变的效果。方法：对平谷区医院相关DRGs指标以及基层住院和试点乡镇门诊相关数据进行比较。结果：急症短期住院费用增长得到控制、药占比等下降；基层医疗机构不必要住院大幅降低、基层门诊回流。结论： 北京市平谷区采用急症短期住院按诊断相关组（DRGs）、慢病长期住院按床日和与签约服务相结合的门诊按人头付费的新农合综合支付方式改革试点数据显示，医院工作效率提高并可获得相应控费激励性收益，体现了医保支付方式有效引导医疗行为的效果。 |
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| Evidence Analysis On The Effects of Combined Insurance Payment System Reform And It’s Guiding Influences To Medical Services |
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| Abstract: |
| Abstract: Objective: To evaluate the results of pilot combined payment system reform in Pinggu District of Beijing in some New Rural Cooperative Medical Scheme(NCMS) covered population by the comparative data. Methods: The DRGs data of Pinggu District Hospital, in-patient data in the primary hospitals and the out-patient data of two pilot towns are collected and compared. Results: Data analysis shows that the hospitalization expenses have been keeping stable, either the ratio of drug expenses or patient self-payment has been decreasing. Unnecessary hospitalization in primary hospital has been reduced significantly, outpatient visits to primary clinics have been increased. Conclusion: The data analysis indicates that hospitals get reasonable return on improving work efficiency and controlling the increase of care expenses which reflects the guiding influences of payment system on the behavior of hospitals and doctors. |
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