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目的:当前剖宫产率过高已成为严重的公共卫生问题。通过该实验来验证定额付费对医院降低剖宫产率的作用,为新医改政策的落实提供实证依据。方法:对参合孕产妇住院分娩实行定额付费,即:不论平产、阴道助产、剖宫产均支付同等数额的住院费用。将定额付费作为实验因素,观察干预组与对照组、干预组实施前后剖宫产率、平均住院费用和死亡率等指标变化。结果:干预地区实施该方法后剖宫产率降低14.08个百分点,平均住院费用降低33.96%。结论:改革付费机制,可以有效改变医院的行为,达到降低剖宫产率、控制费用和提高医疗质量三重目的。
Objective: The current high rate of cesarean section has become a serious public health problem. Through this experiment to verify the fixed fee paid to the hospital to reduce the role of cesarean section, the new medical reform policy to provide an empirical basis. Methods: Inpatient labor for participating maternity fixed fee, that is: regardless of parity, vaginal delivery, cesarean section pay the same amount of hospitalization costs. Fixed fee as an experimental factor to observe the intervention group and control group, intervention group before and after implementation of cesarean section rate, average hospitalization costs and mortality and other indicators change. Results: In the intervention area, the cesarean section rate decreased by 14.08 percentage points and the average hospitalization cost decreased by 33.96%. Conclusion: Reform of payment mechanism can effectively change the behavior of hospitals and achieve the three purposes of reducing cesarean section rate, controlling costs and improving medical quality.