000000cd_白向荣-医院.docVIP

不同付费方式下子宫肌瘤手术医保患者费用的比较研究 白向荣1，周博2 ，Anita Wanger3 ，王育琴1，* 1首都医科大学宣武医院药剂科 100053; 2沈阳药科大学 110016； 3 Department of Population Medicine，Harvard Medical School Boston, MA 02215 *通讯作者 摘要：目的： 探讨不同付费方式下宣武医院治疗子宫肌瘤手术费用的比较研究。方法： 收集宣武医院2005-2008年694例子宫肌瘤手术医保患者的手术费用、总药费、平均药费、治疗效果和住院天数。结果：两组患者在住院时间上不同，在四年内，单病种核算组的平均住院为5天，非单病种核算组为6天。单病种组住院平均费变化趋势不大，而对照组由2005年5937元，下降到4926元。在这两组的变化中，最主要的是主要药费的变化。单病种组的药费1652元下降到1139元，而非单病种组的药费则无明显变化。结论：实行单病种可以有效减少药费及药费比例，缩短住院日，提高医疗工作质量。 关键词：药物经济学 子宫肌瘤 手术 药费 付费方式 Compare Analysis of Different Medical Insurance Coverage for Hysteromyoma Patients in China (Xuan Wu hospital of Capital Medical University 100053; Shenyang Pharmaceutical University 110106) Abstract Objective： Analysis of the different medical insurance coverage of hysteromyoma in Xuan Wu hospital. Methods: To collect the cost，drug cost, average drug cost, treatment outcome and length of days from XuanWu hospital in 2005-2008. Results：The length of days is significant different in both groups. The average length of days in Diagnosis related groups(DRG) is 5 days, however control group is 6 days. The re is no difference in DRG in hospitalizing expense. while the control groups decline from 5937 Yuan in 2005 to 4926 Yuan in 2008. Drug cost is the most changeable value in hospitalizing expense. The most change happened to the drug cost. The drug cost decline from 1652 Yuan in 2005 to 1139 Yuan in 2008 with DRG. But the control group has no difference between 2005 and 2008. Conclusion: The DRG methods can reduce the drug cost and length of days for patients. It can improve the medical quality for the hospital management departments. Key Words: pharmacoeconomics; hysteromyoma; drug cost; medical insurance coverage 所谓单病种付费模式是指通过统一的疾病诊断分类，科学地制定出每一种疾病的定额偿付标准（这个标准接近合情、合理、合法的医疗成本消耗），社保机构按照该标准与住院人次向定点医疗机构支付住院费用，使得医疗资源利用标准化，即医疗机构资源消耗与所治疗的住院病人的数量、疾病复杂程度和服务强度成正比。按病种付费的特点是，医疗机构的收入仅与每个病例及其诊断有关，而与医疗机构治疗该病例所花费的实际成本无关。简而言之，就是明确规定某一种疾病该花多少钱，从而既避免了医疗单位滥用医疗服务项目、重复项目和分解项目，防止医院小病大治，又保证了医疗服务质量，而且操作十分简便。 2.1