| 引用本文：马元元, 胡华杰, 洪妍, 管晓东, 史录文.中国县级公立医院医保支付方式改革与医院控费策略研究[J].中国卫生政策研究,2019,12(11):29-33 |
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| 中国县级公立医院医保支付方式改革与医院控费策略研究 |
| 投稿时间：2019-09-01 修订日期：2019-10-06 PDF全文浏览 HTML全文浏览 |
| 马元元1, 胡华杰1, 洪妍1, 管晓东1,2, 史录文1,2 |
1. 北京大学药学院 北京 100191;
2. 北京大学医药管理国际研究中心 北京 100191 |
| 摘要:目的：分析六省部分县级公立医院医保支付方式与医院控费策略的实施情况，探讨医保支付方式与医院控费策略选择之间的相关性，为改进医保支付方式，优化医院控费策略提供建议。方法：采用问卷调查的方式收集并描述样本医院医保支付方式和医院控费策略情况，采用Stata 14.0软件进行数据统计和分析，探究二者之间相关性。结果：按项目付费、总额预付和按病种付费是最主要的支付方式。样本医院采取的控费策略主要有费用控制策略、限制供应策略、质量管理策略等，且其中更多的医院选择了质量管理策略，不同支付方式下的控费策略选择具有显著性差异。结论：医保支付方式和医院控费策略选择之间存在相关性，建议在制定支付方式相关政策时，配套合理医院控费策略降低医院费用超支风险。 |
| 关键词:支付方式 控费策略 总额预付制 |
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| Research on the reform of medical insurance payment method and hospital cost control strategy in China county public hospital |
| MA Yuan-yuan1, HU Hua-jie1, HONG Yan1, GUAN Xiao-dong1,2, SHI Lu-wen1,2 |
1. School of Pharmaceutical Sciences, Peking University, Beijing 100191, China;
2. International Research Center for Medicinal Administration, Peking University, Beijing 100191, China |
| Abstract:Objective:To analyze the implementation of medical insurance payment method and hospital cost control strategy and to explore the correlation between medical insurance payment method and hospital cost control strategy in public hospitals within five provinces in China, and to provide suggestions for improvement of medical insurance payment method and optimization of hospital cost control strategy. Methods:The method of questionnaire survey was used to collect and describe the method of hospital medical insurance payment and hospital cost control strategy. Stata 14.0 software was used to carry out data statistics and analysis to explore the correlation between the two. Results:Results showed that the payment by project, total advance payment and payment by disease were the most important payment methods. The cost management measures adopted by the subject hospitals mainly include the cost control strategy, limited supply strategy, quality management strategy, etc., and more hospitals have chosen quality management strategy as their best cost management measure. In addition, there were significant differences in the choice of cost control strategy under different payment methods. Conclusions:There is a correlation between medical insurance payment method and cost control strategy. It is suggested that when making relevant policies on payment methods, the reasonable cost control strategy should be used to reduce the risk of hospital cost overrun. |
| Key words:Payment method Cost control strategy Global budget payment |
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