上海市部分三甲医院实施医疗保险费用控制政策的抽样调查

目的对上海市目前医疗保险费用控制政策进行调查分析,为医疗保险费用的控制提出可行性建议。方法对5所上海市三级甲等医院400名医生和患者进行问卷调查,问卷结果使用Microsoft Excel 2000工作表进行归纳,同时收集上海市仁济医院医疗保险办公室2001年~2006年的报表数据,对数据进行统计分析。结果医保总额控制为医患双方所接受,按病种收费是比较理想的方式,药品费用的控制是医患双方关注的焦点。结论根据此次抽样调查结果显示上海市部分三级甲等医院自实行医保费用总额控制以来,医疗保险费用得到了有效的控制,其关键在于对医疗实践中供方和需方不合理医疗消费行为进行了制约。

Survey on medical insurance expenditure control policy in Shanghai's tertiary first-class hospitals

Objective To investigate the current policy of medical insurance expenditure control in Shanghai and put forward feasible advice. Methods Survey in 5 tertiary first-class hospitals in Shanghai involving 400 doctors and patients was conducted.The result of the questionnaire was tracked with Microsoft Excel 2000.The expense reports during 2001 to 2006 from the Office of Medical Insurance of Shanghai Renji Hospital was collected.All the data were statistically analysed. Results The global budget system was accepted by both the doctors and patients.Charging based on disease categories was proved a relatively satisfying method.Drug expenditure control was concerned by both the doctors and patients. Conclusion Ever since the global budget system of medical insurance is implemented in Shanghai,the medical insurance expenditure has been effectively controlled.The key point is the restraint of irrational consumption during the medical treatment.