| 引用本文: |
何亚盛,章湖洋,景日泽,等.北京市二三级医院总额预付实施效果评价[J].中国卫生经济,2017,(9):35-38.[点击复制] |
.Effect evaluation of global budget of medical insurance about the secondary and tertiary hospitals in Beijing[J].CHINESE HEALTH ECONOMICS,2017,(9):35-38.[点击复制] |
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| 摘要: |
| 目的：分析总额预付实施前后北京市二三级医院运行状况的变化，探讨总额预付对不同级别的医院影响的差异，从而评价总额预付的实施效果，发现存在的问题并提出建议。方法：使用《北京市卫生工作统计资料汇编》2007-2014年的数据，采用描述性统计和固定效应模型进行分析。结果：总额预付有效控制了二三级医院的药占比且对三级医院的次均费用控制效果优于二级医院，但是难以控制三级医院的服务量；固定效应模型显示总额预付能控制二级医院的业务收入，但是对三级医院业务收入没有影响。结论：总额预付取得一定效果，但是难以控制三级医院院均业务收入，应该切实推行分级诊疗并精细化测算总额预付基金数额。 |
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| Effect evaluation of global budget of medical insurance about the secondary and tertiary hospitals in Beijing |
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| Abstract: |
| Objective: To analyze the change of the operation status of the secondary and tertiary hospitals in Beijing after the implementation of the global budget of medical insurance, and to explore the effect of the global budget on different levels of hospitals, find prob lems and make recommendations. Methods: The data comes from Beijing Health Work Statistics Collection (2007-2014), and we employ descriptive statistics and fixed effect models to analyze the data. Results: The global budget of medical insurance effectively controlled the drug revenues proportion and the average cost of secondary and tertiary hospitals, and the cost control effect of tertiary hospitals was better than that of secondary hospitals, but it was difficult to control service volume s of tertiary ho spitals. The fixed effect model showed that the global budget of medical insurance can control the secondary hospital service revenues, but has no effect on the tertiary hospital service revenues. Conclusion: The global budget of medical insurance has some positive effect s on hospital performances in Beijing, but it is difficult to control tertiary hospital service revenues. Hierarchical medical system is needed in China and the amounts of global budget should be calculated carefully. |
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