广州市某三甲医院职工医保患者恶性肿瘤门诊费用与住院费用比较

摘要

Objective:To understand the characteristics of expenses of outpatient and hospitalization of malignant tumor patients with health care expenses,and discuss to perfect the cost control policy.Methods:A total of 36512 cases of medical insurance patients were selected from January 1,2014 to December 31,2016,and the detailed data were analyzed by using Pivot Table function.Results:The rate of return of cancer patients increased year by year.The number of outpatient growth rate is about 2 times of hospitalized patients.The number of people in the number of cases is about 5 times of hospitalization patients and grow rapidly.The number of retirees' hospitalization decreased year by year.The total cost per capita and the amount of personal payment rose year by year.The cost of outpatient clinics was significantly higher than that of hospitalization.Western medicine and Chinese medicine costs were steadily down,and Chinese patent drug and material costs increased year by year.Conclusion:We can prevent excessive medical treatment by adjusting the payment policy of demander,prevent excessive medical treatment by refining the supplier payment system,achieve the purpose of control fee by improving the comprehensive prevention and treatment of cancer,strengthening the "early diagnosis and treatment" and other measures.%目的:了解职工医保恶性肿瘤患者门诊费用与住院费用运行特点,探讨健全完善控费策略.方法:收集广州某三甲医院2014-2016年36512例职工医保患者恶性肿瘤门诊费用与住院费用,运用数据透视表功能进行描述性统计分析.结果:恶性肿瘤患者人次人头比逐年上升,门诊人次增长率约为住院人次的2倍,人次人头比约为住院人次人头的5倍且增长较快,退休人员住院人次占比逐年下降;人均总费用、个人自付金额逐年上升,门诊费用增幅明显高于住院费用;西药费、中药费稳中有降,而中成药、材料费逐年上升.结论:通过调整需方支付政策,防止过度就医;细化供方支付措施,防止过度医疗;完善肿瘤综合防治,加强“早诊早治”等措施,达到控费目的.