浅谈新形势下如何降低医保患者住院医疗费用

目的通过对城镇职工基本医疗保险(以下简称医保)患者与自费患者住院医疗费用及其构成因子的研究,找到影响医保患者住院医疗费用高于自费患者的关键因素,从而为制定相关医疗费用控制与管理措施、合理有效地控制医保患者医疗费用提供参考依据。方法根据2011年度出院医保患者与自费患者医疗费用为基本资料,利用统计学的方法对两者的医疗费用以及构成因子(包括药品费用、检查费用、治疗费用等)进行对比与分析。结果医保患者比自费患者人均医疗费用高出20%以上,其中药品费用的增长是医保患者费用增长的主要方面。结论严格控制药品费用是控制医保患者医疗费用增长的关键。

Strategies to Reduce Medical Insurant Inpatient Costs under the New Situation

Objective To study and compare the cost and component factors of inpatients at their own expense and inpatients with basic medical insurance for urban workers,survey the key factors that influence the difference in hospitalization expenses,and provide a reference basis for the establishment of medical cost control and management measures,and for the effective control of medical cost of inpatients with basic medical insurance.Methods The materials about the hospitalization expenses of inpatients with basic medical insurance and inpatients at their own expense in the year 2011 were taken to analyze the cost and its component factors,including the drug costs,inspection costs,treatment costs,etc.Results The cost of patients with basic medical insurance was 20 percent higher than the inpatients at their own expense,in which the drug costs played a lead role.Conclusion To strictly control the drug costs is the key to decrease the medical costs of patients with basic medical insurance.