| 引用本文：孙杨,谢双保,张敏,等.河南省宜阳县供方支付制度改革效果评估[J].中国卫生政策研究,2013,6(3):26-30 |
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| 河南省宜阳县供方支付制度改革效果评估 |
| 投稿时间：2012-10-13 修订日期：2013-02-22 PDF全文浏览 HTML全文浏览 |
| 孙杨1, 谢双保2, 张敏2, 吴建3, 赵要军4, 孟庆跃1 |
| 1.北京大学中国卫生发展研究中心;2.河南省卫生厅;3.郑州大学公共卫生学院;4.华中科技大学同济医学院医药卫生管理学院 |
| 摘要:目的：分析河南省宜阳县支付制度改革的做法和效果。方法：通过机构现有资料与数据收集，对宜阳县支付制度改革机构覆盖、费用与用药情况进行分析。结果：新的支付方式覆盖率在县医院超过65%，药占比与抗生素使用率持续降低，住院收入的平均增长速度（6%）低于医院整体收入增速（98%）。结论：宜阳县的支付制度改革覆盖面较高，是宜阳县目前改革的突出成果之一，部分改革效果指标已经出现良好的发展趋势。但改革依然处于起始阶段，需要进一步关注支付病种数量、覆盖面的变化，以及可能出现的住院和门诊患者之间的成本转移情况，同时改进支付标准测算方法，进行精细化管理，以实现改革目标。 |
| 关键词:新型农村合作医疗 支付方式 标准化 |
| 基金项目:世界银行贷款/英国政府赠款中国农村卫生发展项目（卫XI HN ZX 2011 3） |
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| Evaluation on payment system reform practices of Yiyang County, Henan Province |
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| Abstract:Objective： This paper analyzes the practices and effect of provider payment system reform of Yiyang County, Henan Province. Methods: Collection of existing information and data, and the indicators include payment coverage, expenditure and drug use. Result: The new payment cover more than 65% inpatients and hospitalization expenditure in the county hospital, the proportion of drug use and antibiotic usage continue to decrease, hospitalization revenue growth rate（6%） is lower than the growth rate of the overall revenue（98%）. Conclusion: Yiyang has high case based payment coverage in institution, and it’s one of the achievement of Yiyang’s reform. Part of effect indicators of reform have shown good changing trend. The reform is still in the initial stage, Yiyang needs further attention on the number of case based diseases for payment reform, coverage changes of payment, and especially pay attention on the cost shift from inpatient case to outpatient case. At the same time, Yiyang also needs improvement of payment standard calculation method, and meticulous of manage and implement of the reform measures. |
| Key words:New Rural Cooperative Medical Scheme Payment form Standardize |
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