上海市三级综合医院总额预付制相关指标分析

目的：通过分析上海市三级综合医院相关指标，了解实行总额预付制后医疗服务质量和效率的变化。方法采集2010-2012年上海市14家三级医院医疗服务质量和效率的相关指标，分析实施总额预付制后，医疗费用、平均住院日、药占比、门急诊人次、出院人次、手术人次等指标的变化。结果实施总额预付制后，医疗费用控制较好，平均住院日、药占比下降；门急诊人次、出院人次、手术人次中医保患者和非医保患者所占比例出现不同。结论总额预付制实施总体效果较好，在提高医疗服务效率的同时，保证服务质量不受影响有待进一步研究。

Analysis on Related Indexes after Global Budget in Tertiary Comprehensive Hospital of Shanghai

Objective To indicate the changes of quality and efficiency of medical service after the imple-mentation of the global budget by analyzing the relevant indexes of tertiary comprehensive hospitals in Shanghai . Methods To collect relevant indexes of medical service quality and efficiency from 14 Shanghai hospitals in 2010 to 2012, analyzing the changes of indicators：medical expense, average length of stay, drug proportion, the number of outpatient and emergency , the number of discharged patients , surgical times and etc.Results Under the sys-tem of global budget, medical expense is better controlled, average length of stay and drug proportion decrease .In the indexes of the number of outpatient and emergency , the number of discharged patients and surgical times , there shows different proportion between patients who have got medical insurance and those who have not .Conclusion The global budget got better results, but how to improve the efficiency of medical services as well as ensure the quality of the services needs our further study .