紧密型县域医共体医保打包支付对患者就诊流向的影响
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1.福建医科大学卫生管理学院;2.福建医科大学图书馆

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Effect of Medical Insurance Package Payment in County Medical Community on Flows Direction of Patient
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    摘要:

    为分析紧密型县域医共体医保打包支付对患者就诊流向的影响,本研究选取福建省某国家试点医共体,采用描述性分析和间断时间序列分析等方法研究该医共体实行医保打包支付前后患者就诊流向指标变化。结果显示改革后门诊患者县域就诊人次、县域就诊率上升,住院患者县域就诊率下降趋势放缓;门诊患者基层就诊率下降,住院患者基层就诊人次、基层就诊率下降趋势放缓。医共体实行医保打包支付有助于引导患者回到县域内就诊,但尚未推动患者向基层分流。未来需进一步完善医保打包支付机制,提升医共体整体及基层服务能力,落实配套制度建设,以引导患者合理就医。

    Abstract:

    In order to analyze medical insurance package payment in county medical community on flows direction of patient, this study selected a national pilot county medical community in Fujian and descriptive analysis and interrupted time series analysis were used to study the change in the flows direction of patient before and after the implement of medical insurance package payment. The results show that, after implement of medical insurance package payment, the outpatients treatment volume and visit rate of county were increasing, and the decreasing trend of inpatient visit rate of county slowed down; the outpatients visit rate of basic-level medical institutions decreased,and the inpatients treatment volume and visit rate of basic-level medical institutions. The implement of medical insurance package payment in county medical community helps to to guide patients to go back to the county, but has not yet promoted the flow of patients to basic-level medical institutions. In the future, it is necessary to further improve the mechanism of medical insurance package payment, improve the overall service capacity of the medical community and basic-level medical institutions, implement the construction of supporting systems, and guide patients to seek medical treatment in an orderly manner.

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  • 收稿日期:2023-02-07
  • 最后修改日期:2023-04-09
  • 录用日期:2023-04-10
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