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背景 目前我国医院的收费制度基本上是按照医疗服务项目收费,把诊断治疗、基本服务、仪器设备细化到每一个项目上。据了解,1999年北京市共划分4 600多项服务项目。按项目收费实行多年来,存在很多问题,如有的医院重复检查和化验,有的医院分解项目收费,比如针灸,本来一次性收费四元钱,这四元钱里包括眼针、耳针和头针等,但医生不愿意这么干,他把针灸分成两次做,每次都能收四元钱。有的医院盲目开展新项目,比如阑尾炎,使用了完全没必要使用的高档设备,有的医院竟然使用了“太空舱”,使用一次就多出了2000元钱。虽然对每一个项目有明确的收费标准,但对每一个病种来说,医院到底该是用什么项目,整个疗程中该使用哪些项目,目前为止还没有统一的规范。 从1999年,北京市医疗保险中心开始对医院进行监测,一共监测了48个单病种,最后结果是,正是因为按照项目收费,导致了同一病种在不同医院差异过大,比如阑尾炎,同样是三级医院,最高的平均达到了6000多元,最低的平均只有2 000出头,差异主要是体现在服务项目上和药费上。
Background At present, the charging system of hospitals in our country basically charges according to the medical service items, and the diagnosis and treatment, basic services, equipment and equipment are refined to each item. It is understood that in 1999 Beijing divided a total of more than 4,600 service items. According to the implementation of project fees over the years, there are many problems, such as repeated hospital tests and laboratory tests, and some hospitals to break the project fees, such as acupuncture, had a one-time fee of four yuan, which includes four yuan eye needle, ear and needle Scalp, etc., but the doctor did not want to do that. He divided the acupuncture into two, and each time he received four yuan. Some hospitals blindly carry out new projects, such as appendicitis, the use of completely unnecessary use of high-end equipment, and some hospitals even use the “capsule”, once used more than 2,000 yuan. Although there is a clear fee for each project, but for each disease, the hospital in the end what is the project, the entire course of treatment which projects to use, so far there is no uniform norms. Since 1999, the Beijing Municipal Center for Medicare Insurance started monitoring the hospitals and monitored a total of 48 single diseases. As a result, it was precisely because of the project charges that the same diseases were greatly different in different hospitals such as appendicitis, The same is a tertiary hospital, the highest reached an average of more than 6,000 yuan, the lowest average only 2 000 early, the difference is mainly reflected in the service items and drugs.