| 引用本文：沈娟,简伟研,谢铮,等.支付方式对住院分娩费用的影响——基于四所县医院的抽样调查[J].中国卫生政策研究,2012,5(6):60-64 |
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| 支付方式对住院分娩费用的影响——基于四所县医院的抽样调查 |
| 投稿时间：2012-05-01 修订日期：2012-05-21 PDF全文浏览 HTML全文浏览 |
| 沈娟1, 简伟研1, 谢铮1, 郭岩1 |
| 北京大学公共卫生学院 |
| 摘要:目的：分析不同支付方式对住院分娩服务费用的影响，以及是否可以降低个人自付费用。方法：使用双重差分的方法，以按项目付费为对照组，分析按人头付费、单病种付费—剖宫产控制、单病种付费在住院分娩补助项目实施前后对不同分娩方式分娩费用的影响。结果：按人头付费和单病种付费可以有效降低顺产的住院分娩费用和个人自付费用，但按人头付费对剖宫产的住院分娩费用无影响。结论：支付方式改革确实可以控制医疗费用和个人自付费用，但同时必须注意服务类型的影响。 |
| 关键词:住院分娩 支付方式 医疗费用 个人自付费用 |
| 基金项目:国家自然科学基金（71173006） |
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| The impact of provider payment on expenses institutional delivery： Survey study based on four county hospitals |
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| Abstract:Objective: To analyze the impact of different payment methods on hospital delivery expenses in rural area, and whether it decreased the out of pocket expenses for the rural women to use the hospital delivery services. Method: We carried out difference in difference analysis for hospital delivery expenses using capitation payment and case based payment， with fee for service as the control group. Results: Capitation and case based payment can effectively reduce the total expenses and the out of pocket expenses of the spontaneous delivery for the rural women using the hospital delivery service, but the capitation payment has no effect on the expense of cesarean section. Conclusion: Payment reforms can control the health care expenses and the out of pocket expenses, but the effects varies according to different types of health services. |
| Key words:Institutional delivery Provider payment Medical expense Out of pocket expenses |
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