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医保统筹费用的预算与模拟监控初探

Budget and simulation control of the cost of health care as a whole

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【作者】 陈立王安民夏敏李春菊贺建张兴玉

【Author】 Chen Li;Wang Anmin;Xia Min;Li Chunju;He Jian;Zhang Xingyu;Mianyang Central Hospital;

【机构】 绵阳市中心医院

【摘要】 目的 探索多区域医保统筹费用在医院各专业的预算方式,以便在区域医保统筹费用框架范围内,实施合理的监控。方法 根据多个区域医保统筹费的要求,以医院各专业工作量为基础,前瞻性的预算各专业不同区域的医保统筹费用,并模拟跟踪监控。结果 通过模拟监控,预算的工作量与预算的各专业医保统筹费用波动一致,预算的各专业医保统筹费用值与半年实际发生值的统计检验无显著差异。结论 本预算和模拟监控方法简单便捷、符合实际,可供同行参考和进一步探讨。

【Abstract】 Objective To explore the budget method of the overall arrangement of the regional medical insurance expenses in each specialty in the hospital,and to monitor properly within the scope of overall arrangement expenses of the regional medical insurance.Methods According to the requirements of multiple regional health care undertakings,on the basis of the workload of each specialty of the hospital,we budgeted prospectively the overall arrangement of the medical insurance expenses of each specialty in different regions,and simulated tracking monitoring.Results Through simulation monitoring,the fluctuation of the budgeted workload was in line with the budgeted overall expenses of the medical insurance of each specialty,and there was no statistical significance in the budgeted values of overall expenses of the medical insurance of each specialty and in the actual values of the half year.Conclusion The method of budget and simulation monitoring is simple,convenient,and realistic,and can provide the reference to peers and further discussion.

  • 【文献出处】 中国医院统计 ,Chinese Journal of Hospital Statistics , 编辑部邮箱 ,2013年06期
  • 【分类号】R197.1
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