| 引用本文：周召梅,徐林山,汪利民.定点医疗管理下的门诊服务利用与费用分析：以杭州A医院为例[J].中国卫生政策研究,2009,2(2):27-30 |
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| 定点医疗管理下的门诊服务利用与费用分析：以杭州A医院为例 |
| 投稿时间：2009-02-02 修订日期：2009-02-13 PDF全文浏览 HTML全文浏览 |
| 周召梅1, 徐林山2, 汪利民1 |
| 1.杭州市第一人民医院;2.杭州市医疗保险管理服务局 |
| 摘要:目的：探讨定点医疗管理对参保人员门诊服务利用的影响。方法:采用Excel 2003和SPSS 12.0对数据进行分析。结果：2007年上半年门诊两周就诊率呈逐月上升趋势，下半年基本维持在60.0‰左右；各月医保基金支付额占门诊医疗费的比重呈“U”型分布，门诊次均费用逐月上升，下半年增长迅速；次均费用、两周就诊率与统筹基金支付比重有相关关系。结论：定点医疗管理办法提高了居民的门诊服务利用水平，减轻了患者的疾病经济负担，提高了医保基金的使用效率。 |
| 关键词:定点医疗管理 门诊统筹 门诊服务利用 费用 |
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| Analysis for the utilization and expenses of the outpatient service under contracted medical management：a case from Hangzhou A hospital |
| ZHOU Zhao-mei1, XU Lin-shan2, WANG Li-min1 |
| 1.Hangzhou First Peoples Hospital;2.Hangzhou Medical Insurance Administration Bureau |
| Abstract:Objective: To discuss the effect of contracted medical management on outpatient service utilization. Methods: Data is analyzed mainly by Excel 2003 and SPSS 12.0. Results: Two week visit rate increased in the first half of 2007 and maintained about 60.0‰ in the second half year. The proportion of medical insurance fund paid in outpatient expenses each month changed as U shape. The average outpatient service expenses per visit increased month by month, and even dramatically in the second half year. The average outpatient service expenditure per visit and two week visit rate have a significant relationship with the proportion of social pooling fund paid in outpatient expenditure. Conclusions: The method of contracted medical management improved outpatient service utilization, reduced individual burden of disease and increased the use efficiency of medical insurance fund. |
| Key words:Contracted medical management, Social pooling of outpatient, Outpatient service utilization, Expenses |
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