总额预付制下北京市某三级综合医院绩效指标现况调查

摘要

目的：了解医疗保险支付改革方式对医院成本管理活动以及公立医院绩效产出的影响。方法：利用整群随机抽样的方法，结合数据分析，选取住院患者次均费用、平均住院日、门诊次均费用、门诊拒付金额4项指标的变化进行对比检验。结果：总额预付制实施前后，医院住院患者平均住院日、门诊处方次均费用、门诊拒付金额与总额预付制的实施差异有统计学意义，对住院患者次均费用的影响不显著。结论：实施总额预付制，医院主要绩效产出指标有不同程度的下降，初步起到了约束医疗费用过快增长、改变医院运营行为扭曲现象的作用。为保障服务质量，还需进一步建立健全相关机制，为优化医院成本管理提供参考。%Objecit ve: To investigate the impacts of Medicare payment reform to public hospital cost management activities and performance output.Mte hods:Using cluster random sampling method and case studies, combined with data analysis, to compare the changes for four perform-ance output, such as the inpatient per capita health care costs, average length of stay, outpatient per capita health care costs, outpatient refuse to pay the amount , which is analyzed by statistical data.Results: The average length of stay, outpatient per capita health care costs and outpatient refuse to pay the amount have statistics significance with the Global Budget, and has no significant impact on the inpatient per capita health care costs.Conclusion: Implement the Global Budget, hospital performance output index have different degrees of decline, played a preliminary con-straints effect of rapid growth of medical costs , changing the distorted phenomenon of hospital operations behavior.To protect the service quality, need to establish and improve the further mechanisms, provide a reference for optimizing hospital cost management.