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目的:通过研究子宫肌瘤及慢性支气管炎患者住院费用的变化情况以及不同支付方式对于住院费用控制的效果,分析混合式支付方式对住院费用的影响。方法:对A市B医院2011—2015年522例子宫肌瘤患者及1102例慢性支气管炎患者的病案首页、一日清单以及新型农村合作医疗患者就诊明细数据进行统计学描述与分析。结果:子宫肌瘤患者住院次均费用变化波动,慢性支气管炎患者的住院次均费用变化趋势平稳。不同支付方式患者人次结构随支付标准的变化而变化。结论:由于对按项目付费的准入和不同支付方式之间的选择及转换监管力度不够,供方趋于将患者推向支付标准更高的支付方式,缺乏精算管理和有效监管的混合式支付方式对住院费用控制效果不明显。
OBJECTIVE: To study the effect of hybrid payment on hospitalization by studying the changes of hospitalization costs in patients with uterine fibroids and chronic bronchitis and the effect of different payment methods on hospitalization costs. Methods: A total of 522 patients with uterine fibroids and 1102 patients with chronic bronchitis from 2011 to 2015 in City B were enrolled in the first page of medical records, the first day list and the detailed information of the new rural cooperative medical patients. Results: Uterine fibroids fluctuated in the average cost of hospitalization, the average cost of hospitalization for patients with chronic bronchitis showed a stable trend. The patient structure of different payment methods varies with the payment standard. CONCLUSIONS: As providers of fee-for-program access and inadequate regulation of transitions between different payment options tend to push providers to pay higher standards of payment, lack of actuarial management and effective supervisory hybrid payments Way to control the cost of hospitalization is not obvious.