北京市护理院收费方案和标准的探索性研究

摘要

Objective:To formulate charging scheme and charging standards for Beijing nursing home, to demonstrate the feasibility of charging scheme and rationality of charging standards, and to provide further reference for adjusting charging scheme and standards in nursing homes. Methods: We compared basic nursing service fee of long-term hospitalized patients (beds, nursing, nursing treatment, medical fee and tempering fee) in secondary and tertiary comprehensive hospitals and average fee of endowment institutions to formulate the average basic nursing service fee standard (namely package fee) in nursing home. We compared the predicted cost and actual cose of hospitalized patients in the pilot units of nursing home. Results: ① According to ADL grade, the basic nursing service fee standards were divided into three levels: 1800 yuan/month for ADL mild dysfunction patients, 2200 yuan/month for ADL moderate dysfunction patients and 2800 yuan/month for ADL severe dysfunction patients; ② The predicted cost were slightly higher than actual cost of patients in pilot units of nursing home. Conclusions: ① Currently, the whole set of legal fees plus theory hourly amount is the ideal payment style for nursing home; ② The basic nursing service charging standards can maintain nursing home survival and normal operation.%目的:制定北京市护理院收费方案及收费标准,论证收费方案的可行性和检验收费标准的合理性,为今后护理院收费方案及标准的调整提供参考依据.方法:比对二级、三级综合医院长期住院患者基本护理服务费和北京市养老机构平均收费标准,制定护理院的基本护理服务费收费标准,将预测费用与护理院试点单位患者的实际费用进行对比.结果:①护理院的基本护理服务收费标准根据ADL分级划分为3个等级,即ADL轻度功能障碍患者1800元/月,ADL中度功能障碍患者2200元/月,ADL重度功能障碍患者2800元/月;②护理院试点单位患者的预测费用较实际费用略高.结论:①整体费用组合法加论量计酬是护理院目前较为理想的付费方式;②基本护理服务费用标准能维持护理院的生存与正常运营.