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目的 分析住院病种费用效益变动趋势 ,探讨控制医疗费用不合理过度增长的有效途径。方法 对1996— 1997年全国铁路医院 2 0个住院病种 ,共 15 3 396例住院病人的例均费用、例均药品费、药品费用占总费用的百分比、例均其它费用 4项指标采用RSR进行动态对比综合分析。结果 ① 1997年与 1996年相比 ,例均住院费用、例均药品费与药品费占总费用的百分比均明显上升 (P <0 .0 5 )。② 2 0个住院病种费用效益 ,除甲状腺癌和急性阑尾炎外 ,其余 18个病种均较 1996年有所下降。③例均费用中 ,仅结肠癌、甲状腺癌 2个病种略有下降 ,其余18个病种例均费用均有上升 ,其中以急性肾炎上升尤甚 ,达 114 12 %。④总费用效益 ,1997年较 1996年明显下降(P <0 0 0 1)。结论 建立城镇职工基本医疗保险制度 ,开展循证医学实践和卫生技术评估 ,实施单病种医疗费用控制 ,对于遏制医疗费用的不合理过度增长具有重要的现实意义
Objective To analyze the changing trend of cost-effectiveness of in-patient diseases and explore effective ways to control unreasonable excessive growth of medical expenses. METHODS: For the 1996-1997 year of the National Railway Hospital, 20 cases of inpatients, a total of 15 3 396 inpatients, the average cost, the average cost of drugs, the percentage of the total cost of the medicines’ expenses, and the other examples of the other expenses. Perform dynamic comparison analysis. Results 1 Compared with 1996 in 1997, the average hospital charges, the average drug costs and the percentage of drug costs in the total expenses increased significantly (P < 0.05). In addition to thyroid cancer and acute appendicitis, the cost of the 22 hospitalized diseases was lower than that of 1996. Of the three cases, only two cases of colon cancer and thyroid cancer showed a slight decrease. The costs of the remaining 18 cases all increased. Among them, acute nephritis increased even more, reaching 11412%. 4 The total cost effectiveness was significantly lower in 1997 than in 1996 (P < 0 01). Conclusion The establishment of a basic medical insurance system for urban workers, the implementation of evidence-based medical practice and health technology assessment, and the implementation of single-disease medical cost control are of important practical significance for curbing the unreasonable excessive growth of medical expenses.