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为了验证“总额预算+按服务单元付费”组合支付方式在实际推广过程中的现实可操作性,研究以“协调各方利益,实现预期效果”为目标,设计了简单易操作的适用于全国、省、市、县,乃至单个医疗机构的设计思路和方法,并运用华东地区某省卫生财务年报资料进行了现实模拟设计,测算得2009年华东地区某省医疗机构的业务收入总额医疗费用应控制在400.5亿元之内,不同类型和级别的医疗机构中,以城市医院为例,其门诊次均费用和住院床日费用的收费标准分别为228.5元和697.3元。证明“总额预算+按服务单元付费”组合支付方式是易操作可推广的,为组合式支付方式的现实实行、实现医改突破提供技术支撑。
In order to verify the practical operability of the “total budget + pay by service unit” combination payment method in the actual promotion process, the research aims to “coordinate the interests of all parties and achieve the expected results”, and design a simple and easy-to-use It is applicable to the design ideas and methods of the national, provincial, municipal, county and even a single medical institution. The data of annual health financial annual report of a certain province in east China are used to carry out the realistic simulation design. The estimated total business income of a medical institution in a province in east China in 2009 Medical expenses should be controlled within 40.0 billion yuan. Among the different types and levels of medical institutions, urban hospitals, for example, have a fee of 228.5 yuan and 697.3 yuan respectively for out-patient average costs and hospital bed-days fees. Prove “total budget + pay by service unit ” combination payment method is easy to operate and can be promoted, providing technical support for the implementation of the combination of payment methods, medical breakthroughs to achieve breakthroughs.