论文部分内容阅读
1998年,上海市普陀区医疗保险办公室改革公费医疗支付方式,对门诊项目实行按人头付费。本文就改革实施一年来公费医疗费用发生情况作一分析,对按人头付费方式实施效果进行评估,得出以下结论:该支付方式较为有效地降低了医疗费用的增长幅度,减少了浪费;对促进医院加强内部管理,转变经营策略,重视医疗成本控制,提高卫生资源的利用效率起到了积极的作用。同时提出,要注意纠正个别医疗机构控制费用方法简单化的偏差,要考虑人群年龄结构因素对医疗费用的影响,适当调整付费标准,以避免医疗机构在承担费用支出方面出现畸轻畸重的问题。
In 1998, the Shanghai Putuo District Medical Insurance Office reformed the public medical payment method and paid per capita expenses for outpatient services. This article makes an analysis of the occurrence of publicly-funded medical expenses in the implementation of reforms over the past year and evaluates the effect of the per-person payment method. The following conclusions are drawn: The payment method is more effective in reducing the growth rate of medical expenses and reducing waste; The hospital has strengthened its internal management, changed its business strategy, attached importance to medical cost control, and improved the utilization efficiency of health resources. At the same time, it is proposed that attention should be paid to correcting deviations from the simplification of the control method for individual medical institutions. The impact of population age structure factors on medical expenses should be taken into account, and payment standards should be appropriately adjusted to avoid the occurrence of terribly serious problems for medical institutions in assuming expenses.