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目的通过对城镇职工基本医疗保险(以下简称医保)患者与自费患者住院医疗费用及其构成因子的研究,找到影响医保患者住院医疗费用高于自费患者的关键因素,从而为制定相关医疗费用控制与管理措施、合理有效地控制医保患者医疗费用提供参考依据。方法根据2011年度出院医保患者与自费患者医疗费用为基本资料,利用统计学的方法对两者的医疗费用以及构成因子(包括药品费用、检查费用、治疗费用等)进行对比与分析。结果医保患者比自费患者人均医疗费用高出20%以上,其中药品费用的增长是医保患者费用增长的主要方面。结论严格控制药品费用是控制医保患者医疗费用增长的关键。
Objective To find out the key factors influencing the hospitalization medical expenses of medical insurance patients higher than those of patients who pay for their own expenses through the research on the hospitalization medical expenses and its constituent factors of urban workers basic medical insurance (hereinafter referred to as Medicare) patients and their own expenses patients, so as to find out the relevant medical expenses control and Management measures, reasonable and effective control of Medicare patients provide a reference basis for medical expenses. Methods Based on the medical expenses of patients who were discharged from Medicare and patients at their own expense in 2011 as the basic data, the medical costs and the composing factors (including the cost of drugs, examinations, treatment costs, etc.) were compared and analyzed by using statistical methods. As a result, Medicare patients cost more than 20% of the medical expenses per patient at their own expense, of which the increase of Medicines cost is the main aspect of Medicare patients’ expenses growth. Conclusion Strict control of drug costs is the key to controlling the growth of medical expenses for Medicare patients.