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目的探讨医疗保险制度改革对某院病床工作效率的影响。方法运用质量控制图,对医疗保险制度改革前后,某院病床工作效率指标变动情况进行分析。结果2003年北京市医疗改革开始实施,病人选择性就医的自由度加大,一部分原铁路系统内病人流向了有较大竞争力的北京市大医院,使得医院病床工作效率值骤然下降,特别是非典暴发使病床工作效率值远远低于病床工作效率控制下限。此后铁路系统内病人外流造成的床位“空缺”逐渐被医院服务半径内的其他病人占用。从2003年底开始病床工作效率逐渐缓慢回升,至2007年下半年已超过医改前病床工作效率值平均水平。结论医疗保险体制的改革对医疗机构的内部管理提出了更高要求,医院应规范医疗行为,做到合理检查,合理治疗,合理用药。同时,定期考核医保规章制度执行情况,开展循证医学实践,主动适应并积极应对医疗市场的竞争,价格低、质量优、信誉高的医院将是医改的赢家。
Objective To explore the effect of medical insurance system reform on hospital bed efficiency. Methods The quality control chart was used to analyze the change of hospital work efficiency indicators before and after the reform of medical insurance system. Results In 2003, the medical reform in Beijing began to take place. The patient’s freedom of medical treatment increased. Some of the patients in the original railway system flowed to the larger hospitals in Beijing which made them more competitive. In particular, SARS outbreak so that the value of the hospital bed efficiency is far below the lower limit of efficiency of the hospital bed. Since then, the bed vacancies caused by patient outflow in the railway system have been gradually occupied by other patients within the radius of the hospital service. From the end of 2003, the efficiency of hospital bed gradually recovered slowly, and surpassed the average value of hospital bed efficiency before the reform in the second half of 2007. Conclusion The reform of medical insurance system puts forward higher requirements on the internal management of medical institutions. The hospital should standardize the medical behaviors and make reasonable inspection, rational treatment and rational use of medicine. At the same time, regular review of the implementation of health insurance rules and regulations, to carry out evidence-based medical practice, take the initiative to adapt to and actively respond to the competition in the medical market, low prices, excellent quality, high reputation hospitals will be the winner of medical reform.