摘要
通过分析某医管中心2003年～2006年医保基金收支及转外就医情况,比较我院同期工作量。结果显示,某医管中心的参保人数从31957人增至42999人,转诊人员平均报销率从66%增至70%,人均住院费用下降14.46%,统筹基金支出占基金收入比在88%～91%。我院住院人数增加,病床使用率提高,均住院日下降。表明转诊患者的医疗费用达到合理使用和控制,我院医疗资源使用达到最大化,经济及社会效益回报高。
The medical insurance fund and the referral status in one medical insurance management center from 2003 to 2006 were analyzed retrospectively, and the major admission indexes were compared in our hospital during the same period. From 2003 to 2006, the number of medical insurant in this center was increased from 31 957 to 42 999. Reimburse ratio of referral patients increased, that was up to 70% from 66%. The average hospitalized fee of referral patients decreased 14. 46 %. The overall plan fund of medical insurance was between 88% and 91% of the income of fund. In our hospital, the number of discharge was increased. The average bed occupied rate was risen. The average admitted duration was shortened. It concluded that the referral insurant＇s medical expenditure was reasonable and controllable. In the meantime, our hospital made the whole medical resources and obtained good economic returns and social effects.
出处
《医学与哲学（A）》
CSSCI
北大核心
2009年第1期40-41,共2页
Medicine & Philosophy:Humanistic & Social Medicine Edition
关键词
转诊
医疗费用
管理
referral from different designated medical units, medical care, management
