共查询到18条相似文献,搜索用时 531 毫秒
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目的
分析宁夏银川市三级甲等医院职工基本医疗保险总额预付制的基本运行情况以及综合实施效果变化,为更好的实施总额预付制提供合理的建议。方法 对7家三甲医院2012年以及2013年的出院人次、次均费用、次均医保支付、非医保支付指标进行统计对比,运用秩和比法综合评价7家三甲医院总额预付制实施的效果。结果 2013年7家三甲医院一共透支了34.88%,2013年较2012年次均费用、次均医保支付、非医保支付比例均呈现增长趋势,次均医保支付增长幅度与次均费用增长幅度不成比例,而且次均医保支付增长均远远高于次均费用增长。宁夏人民医院和宁夏医科大总院心脑血管病医院的RSR值小幅度增加,其余5家三甲医院的RSR值均降低。结论 7所三甲医院透支严重,医院承担很大超支的风险和压力,对医院的正常运营会有影响。总体来看,政策没有有效的控制医疗费用的增长,总额预付制的综合运行效果不明显。增强医保中心对医院的管理,医院内部要实行“总额控制、结构调整”的管理,健全信息系统,加强监督与管理。 相似文献
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?????? 目的 旨在探讨总额预付改革形势下的三级公立医院,特别是专科公立医院所应作出的管理策略调整,为进一步深化公立医院改革提供参考依据。方法 通过文献复习、专题讨论等定性分析,结合医院信息系统、市医疗保险事务管理中心的资料,对医院数据纵向对比,对综合、中医、专科三类医疗机构医保数据横向对比。结果 总额预付工作达到了试点要求,提升着医院医保工作管理水平。结论 在继续推动总额预付工作的同时,应适度重视对专科医院的政策倾斜,专科医院也应强化内部基金分配使用和绩效考核的管理,注重单一限额下增强医疗机构的内生活力,将输血与造血有机结合,共葆医保基金的可持续循环。 相似文献
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通过对上海市非医保患者就医现状调查,研究兼顾好不同医疗费用支付形式患者和发挥优质医疗资源共享效能的对策,为建立和优化就医需求引导机制提供政策依据。方法 利用SPSS20.0描述性统计对数据进行分析。结果 非医保患者在沪就医原因列前五位的分别是沪医疗机构技术水平高,疾病需要,设备先进,在沪居住,药品种类齐全;相当比例患者为复诊或随访;平均门诊费用及住院费用高于医保患者。结论 通过有效方法影响就医者行为,引导医疗需求,合理分流和优化在市级综合医院非医保患者的医疗需求,提高优质医疗资源有效利用率。 相似文献
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目的 了解我国二、三级医疗机构医疗纠纷的发生水平、解决方式及赔偿情况,为公立医院医疗纠纷的解决和医疗责任的赔付模式的建立提供科学依据。方法 通过整群抽样选取山西、河北、福建、黑龙江、北京5个省市二、三级27所公立医院,采用统一的问卷调查方式,分别对二、三级医院2011—2013年的基本情况、医疗纠纷发生及医疗责任赔偿等进行调查分析。结果 二、三级医院百名医生医疗纠纷发生率分别为7.96和4.85,医疗纠纷非诉讼解决方式分别是92.72%和82.58%,医疗保险赔偿额分别占赔偿总额29.35%和24.41%。结论 目前我国仍处于医疗纠纷高发期, 医疗纠纷解决的主要途径是非诉讼解决方式,医疗责任的赔付主要来源是医院赔偿。 相似文献
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目的 分析上海市浦东新区区属公立综合医院社区获得性肺炎(CAP)住院诊疗的过程质量。 方法 根据国家卫生和计划生育委员会对社区获得性肺炎(CAP)质量控制的要求,对浦东新区7所区属公立综合医院随机抽取的151份CAP病案进行评价。 结果 浦东新区区属公立综合性医院社区获得性肺炎(CAP)住院诊疗基本符合我国卫生和计生委对社区获得性肺炎(CAP)质量控制的要求;但在检查规范性和抗菌药物合理使用方面,三级医院、北区二级医院和南区二级医院表现不一。 结论 浦东新区卫生行政部门和医院应进一步加强社区获得性肺炎(CAP)质量控制,改进检查和抗菌药物使用。 相似文献
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????? 目的 了解不同地区患者对三级公立医院公益性的评价,探究公益性评价的影响因素。方法 通过问卷的形式,在东、中、西3个地区选择在三级医院就诊的患者进行调查, 使用Pearson Chi-square、非参数检验和Logistic回归方法对数据进行分析。 结果 患者对于公立医院的公益性评价存在一定的地区差异,但公益性总体评价的影响因素类似,医疗服务的适宜性和公平性是主要影响因素。结论 加强三级公立医院的公益性应该着重提高医疗服务的适宜性,提高医疗服务的公平性。 相似文献
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Zhongliang Zhou Zhiying Zhou Jianmin Gao Xiaowei Yang Ju'e Yan Qinxiang Xue Gang Chen 《PloS one》2014,9(4)
Background
Urban population in China is mainly covered by two medical insurance schemes: the Urban Employee Basic Medical Insurance (UEBMI) for urban employees in formal sector and the Urban Resident Basic Medical Insurance (URBMI) for the left urban residents, mainly the unemployed, the elderly and children. This paper studies the effects of UEBMI and URBMI on health services utilisation in Shaanxi Province, Western China.Methods
Cross-sectional data from the 4th National Health Services Survey - Shaanxi Province was studied. The propensity score matching and the coarsened exact matching methods have been used to estimate the average medical insurance effect on the insured.Results
Compared to the uninsured, robust results suggest that UEBMI had significantly increased the outpatient health services utilisation in the last two weeks (p<0.10), whilst the significant effect on hospitalisation was evident in the CEM method (p<0.10). The effect of URBMI was limited in that although being insured was associated with higher health services utilisation, compared with the uninsured, none of the improvement was statistically significant (p>0.10). It was also found that compared with the uninsured, basic medical insurance enrollees were more likely to purchase inpatient treatments in lower levels of hospitals, consistent with the incentive of the benefit package design.Conclusion
Basic Medical insurance schemes have shown a positive but limited effect on increasing health services utilisation in Shaanxi Province. The benefit package design of higher reimbursement rates for lower level hospitals has induced the insured to use medical services in lower level hospitals for inpatient services. 相似文献17.
Institutional care is a growing component of health care costs in low- and middle-income countries, but local health planners in these countries have inadequate knowledge of the costs of different medical services. In India, greater utilisation of hospital services is driven both by rising incomes and by government insurance programmes that cover the cost of inpatient services; however, there is still a paucity of unit cost information from Indian hospitals. In this study, we estimated operating costs and cost per outpatient visit, cost per inpatient stay, cost per emergency room visit, and cost per surgery for five hospitals of different types across India: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed government district hospital, a 655-bed private teaching hospital, and a 778-bed government tertiary care hospital for the financial year 2010–11. The major cost component varied among human resources, capital costs, and material costs, by hospital type. The outpatient visit cost ranged from Rs. 94 (district hospital) to Rs. 2,213 (private hospital) (USD 1 = INR 52). The inpatient stay cost was Rs. 345 in the private teaching hospital, Rs. 394 in the district hospital, Rs. 614 in the tertiary care hospital, Rs. 1,959 in the charitable hospital, and Rs. 6,996 in the private hospital. Our study results can help hospital administrators understand their cost structures and run their facilities more efficiently, and we identify areas where improvements in efficiency might significantly lower unit costs. The study also demonstrates that detailed costing of Indian hospital operations is both feasible and essential, given the significant variation in the country’s hospital types. Because of the size and diversity of the country and variations across hospitals, a large-scale study should be undertaken to refine hospital costing for different types of hospitals so that the results can be used for policy purposes, such as revising payment rates under government-sponsored insurance schemes. 相似文献