总额预付制实施前后北京市门诊医保患者次均费用对比分析

摘要

Objective To analyze the changes of outpatient medical expenses before and after theimplementation of total prepayment system,evaluate the implementation effect of total prepayment system,and discuss the achievements and problems.Methods The cost of outpatient service,pharmacy expense and material cost,outpatient examination cost data were used for comparison by t-test and other statistical methods.Results After the implementation of the total prepaid system,the subtotal cost among insured outpatients decreased 23.15 ％ lower than that before the implementation (P＜0.05),and all other expenses decreased.Conclusion As one of the way to control the rapid growth of medical expenses,the total prepaid system can promote the reasonable allocation of medical resources,avoid the unreasonable expenditure of medical insurance fund,which is worth popularizing widely.%目的 对比分析总额预付制实施前后门诊医保患者次均费用的变化情况,评价总额预付制的实施效果,寻找存在的问题.方法 选取实施前后门诊次均费用、门诊药品次均费用、门诊材料次均费用和门诊检查次均费用等数据,采用t检验等统计方法进行分析.结果 总额预付制实施后门诊医保患者次均费用比实施前下降23.15％,具有统计学意义(P＜0.05),其他各项费用均有所降低.结论 总额预付制作为目前控制医疗费用快速增长的方式之一,可以促进医疗资源的合理配置,避免了医保基金的不合理支出,值得推广和借鉴.