| 城镇职工医疗保险统筹住院次均费用增长分析和对策 |
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| 引用本文： | 陈克绍,;刘恩廷,;张在来.城镇职工医疗保险统筹住院次均费用增长分析和对策[J].未来与发展,2014(8):31-33. |
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| 作者姓名： | 陈克绍 ;刘恩廷 ;张在来 |
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| 作者单位： | [1]南开大学,天津300071; [2]中国人寿合肥分公司,安徽合肥230022 |
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| 摘 要： | 次均费用反映了当今社会普遍关注的看病贵难题,体现医疗保险制度效率。次均费用受多种因素影响,经济、人口结构和质量、医药卫生体制和新诊疗技术的使用是主要影响因素。增加过度治疗的机会成本,当边际成本超过边际收益时定点机构才会加强自律,规范治疗。引导就医流向可以降低来自参保人行为导致的费用增长。医保管理者在控制次均费用增长问题上责任重大,并大有作为。实行按病种支付、对三级医院重点检查、增加平均住院日指标、规定大型设备阳性检查率、充分利用信息平台加强管理等有利于控制次均费用不合理增长。
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| 关 键 词： | 次均费用 过度医疗 医保管理 定点医疗机构 |
Analysis and Countermeasures for Medical Insurance＇s both Times overall Hospitalization Costs Growth of Urban Workers |
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| Institution: | CHEN Ke-shao, LIU En-ting, ZHANG Zai-lai (1.Nankai University, Tianjing 300071, China; 2.Hefei Branch of China Life, Hefei Anhui 230022, China) |
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| Abstract: | Both times the cost reflects the expensive problem of common concern in today＇s society, reflecting the efficiency of the health care system of insurance. Times are affected by many factors cost, the use of economic, demographic and quality of medical and health system, and new medical technology is a major factor. Increase the opportunity cost of overtreatment, when the marginal cost exceeds the marginal revenue designated institutions will strengthen self-discipline, standardize treatment. Guide the flow can reduce the cost of medical treatment resulting from the growth behavior of the insured person. Medicare administrators to control both times on the issue of cost increases responsibility and accomplish much. Implemented by the kinds of paid sick for three hospitals focus on examination, increase in the average length of stay targets, requiring largeequipment positive test rate, full use of the information platform to strengthen management will help control costs are unreasonable times growth. |
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| Keywords: | Both times the cost overtreatment insurance management designated medical institutions |
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