| 引用本文: |
李鑫,李祥飞.区域点数法下三级公立医院费用控制SD模型构建及仿真分析*[J].中国卫生经济,2023,42(12):28-33.[点击复制] |
Li Xin,Li Xiangfei.Research on Cost Control Simulation of Tertiary Public Hospitals under the Background of Region Points Method[J].CHINESE HEALTH ECONOMICS,2023,42(12):28-33.[点击复制] |
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| 摘要: |
| 目的：以天津市某三级公立医院为例，梳理区域点数法总额预算管理模式对医疗费用的内在影响机制，深入研究医疗机构适应性管理措施对费用控制的作用力度，为优化医院管理和规划医院发展路径提供参考。方法：基于CIMO框架呈现改革对医院医疗费用控制影响的系统架构。运用系统动力学理论进一步构建医院控费的SD模型，选取不同管理措施为靶点进行干预，量化研究医疗费用控制情况及发展变化趋势。结果：通过对成本核算、绩效考核、信息化建设、路径规范及病案质控等靶点干预后，对医疗费用发生金额和患者实际负担的下降趋势均产生一定程度的强化，且对患者实际负担影响力度更大。其中，信息化建设、路径规范、成本核算等靶点具有较大的作用强度。结论：增强多科室管理共识与合作、创新工作流程、及时数据反馈和分析，结合医保相关指标调整医务人员绩效管理方案。 |
| 关键词: 区域点数法 公立医院 医疗费用 系统动力学 |
| DOI： |
| 投稿时间：2023-09-01 |
| 基金项目:国家社会科学基金项目 （22BGL223）；天津市卫生健康科技项目 （ZC20036） |
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| Research on Cost Control Simulation of Tertiary Public Hospitals under the Background of Region Points Method |
| Li Xin,Li Xiangfei |
| (Tianjin Central Hospital of Gynecology Obstetrics,Tianjin 300100 ,China) |
| Abstract: |
| Objective: Taking a tertiary public hospital in Tianjin as an example, to sort out the internal mechanism of the influence of the total budget management mode of regional points method on medical expenses, and to deeply study the effect of the adaptive management measures to be taken by medical institutions on cost control under the background of reform. It provides references for optimizing hospital management measures and development path. Methods: Based on CIMO framework, the overall situation of total budget management policy of regional points method in Tianjin was analyzed, and the system structure of the impact of reform on medical cost control in public hospitals was presented. Based on the system dynamics theory, the SD model of public hospital cost control under the method of regional points was further constructed. Different management measures were selected as targets and interventions were carried out to quantitatively study the control situation and development trend of medical expenses in medical institutions. Results: After targeted intervention, cost accounting, performance assessment, information construction, path standardization and medical record quality control, the decreasing trend of the amount of medical expenses and the actual burden of patients was strengthened to a certain extent, and the influence on the latter was stronger. Among them, information construction, path specification, cost accounting has a greater impact. Conclusions: Strengthen the consensus and cooperation of multi-department management, innovate the work flow and timely data feedback analysis, and adjust the performance management plan of medical staff according to the related indicators of medical insurance. |
| Key words: regional point method public hospitals medical expenses system dynamics |
