医疗保险制度改革对某院病床工作效率的影响

目的探讨医疗保险制度改革对某院病床工作效率的影响。方法运用质量控制图，对医疗保险制度改革前后，某院病床工作效率指标变动情况进行分析。结果2003年北京市医疗改革开始实施，病人选择性就医的自由度加大，一部分原铁路系统内病人流向了有较大竞争力的北京市大医院，使得医院病床工作效率值骤然下降，特别是非典暴发使病床工作效率值远远低于病床工作效率控制下限。此后铁路系统内病人外流造成的床位“空缺”逐渐被医院服务半径内的其他病人占用。从2003年底开始病床工作效率逐渐缓慢回升，至2007年下半年已超过医改前病床工作效率值平均水平。结论医疗保险体制的改革对医疗机构的内部管理提出了更高要求，医院应规范医疗行为，做到合理检查，合理治疗，合理用药。同时，定期考核医保规章制度执行情况，开展循证医学实践，主动适应并积极应对医疗市场的竞争，价格低、质量优、信誉高的医院将是医改的赢家。

The Influence of the Reform of the Medical Insurance System on the Work Efficiency of some Hospitals

Objective To explore the effects of the medical security system reform on hospital management and curative. Methods A hospital bed efficiency index before and after the medical security system reform was analyzed through applying the method of quality control chart. Results After the beginning of the railroad medical security system reform in 2003, with the freedom of patients in the selecting hospital increased, the hospital bed efficiency index descend suddenly even lower than that of the lower limit, because parts of patients of our hospital (Railway hospital) went to other hospitals with more competitive ability. Then the hospital bed vacancy caused by the outflow of patients was occupied by the nearby patients in the radius of hospital service gradually and the railway nospital bea. As a result, the efficiency ascended correspondingly and the hospital bed efficiency got close the average level up to the 2007 and the hospital bed efficiency exceed in the end of the 2007. Conclusion The payment mode of the medical security system claims higher requirement to interior management of medical institutions. If the railway hospitals intended to keep the invincible positioning in the tide of reform, they must standardize their medical behaviors to check, treat and medicate the patients legitimately. Simultaneously, we should check the implementation of the regulations of medical care assurance periodically, display the medical cost publicly, and put evidence-based medicine into practice, and adapt to and cope with the health market competition actively and initiatively.