绵阳地区8家医院冠心病患者医药费用控制研究
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摘要
目的了解控制医药费用的必要性和可行性,并探讨医药费控制的措施和方法。方法通过医保信息系统提取绵阳地区8家不同地域不同级别的医院2014年至2016年的冠状动脉粥样硬化性心脏病(简称冠心病)病例,随机抽取1 600份病例资料,回顾性分析医疗费用构成。结果平均住院天数为13. 24 d,人均住院费用为12 052. 22元,平均药占比为35. 19%;冠心病治疗药物金额占总药费的72. 37%,中成药总金额占冠心病治疗用药金额的37. 75%。结论平均住院日高于文献报道。中成药存在扩大化使用、滥用现象。避免药物的不合理使用和滥用,降低药占比,加强医药费用控制和药品监管,降低住院日和药品价格,落实单病种付费,不断完善医保支付方式,能真正使医药费用回归合理,解决"看病贵"的问题。
Objective To understand the necessity and feasibility of controlling medical cost,and to investigate the measures and methods of controlling medical cost. Methods Through the medical insurance system,the patients with coronary heart disease( CHD) were extracted from eight hospitals of different regions and levels in Mianyang from 2014 to 2016,1 600 cases were randomly sampled and the composition of medical cost was retrospectively analyzed. Results The average hospitalization days were 13. 24 d and the average hospitalization cost was 12 052. 22 Yuan. The average drug proportion was 35. 19%,and the amount of drugs for CHD accounted for72. 37% of the total drug cost. The total amount of Chinese patent medicines accounted for 37. 75% of the total cost of medication used in the treatment of CHD. Conclusion The average hospitalization days are longer than those reported in the literature. Chinese patent medicines has been widely used and abused. Avoiding the irrational use and abuse of drugs,reducing the drug proportion,strengthening the control of medical cost and drug administration,reducing the hospitalization days and drug prices,implementing single-disease payment,and constantly improving the payment mode of medical insurance can really make the medical cost return to a reasonable level and solve the problem of ″high cost of getting medical services″.
Objective To understand the necessity and feasibility of controlling medical cost,and to investigate the measures and methods of controlling medical cost. Methods Through the medical insurance system,the patients with coronary heart disease( CHD) were extracted from eight hospitals of different regions and levels in Mianyang from 2014 to 2016,1 600 cases were randomly sampled and the composition of medical cost was retrospectively analyzed. Results The average hospitalization days were 13. 24 d and the average hospitalization cost was 12 052. 22 Yuan. The average drug proportion was 35. 19%,and the amount of drugs for CHD accounted for72. 37% of the total drug cost. The total amount of Chinese patent medicines accounted for 37. 75% of the total cost of medication used in the treatment of CHD. Conclusion The average hospitalization days are longer than those reported in the literature. Chinese patent medicines has been widely used and abused. Avoiding the irrational use and abuse of drugs,reducing the drug proportion,strengthening the control of medical cost and drug administration,reducing the hospitalization days and drug prices,implementing single-disease payment,and constantly improving the payment mode of medical insurance can really make the medical cost return to a reasonable level and solve the problem of ″high cost of getting medical services″.
引文
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[9]曹凯,张晓利.药品支付标准之难[J].中国医院院长,2017(12):57-59.
[2]宋小梅,肖燕兰.中西医结合治疗冠状动脉粥样硬化性心脏病心绞痛临床评价[J].中国药业,2017,26(2):63-66.
[3]向超,甘国兴,饶剑花,等.2013-2015年清远市中医院活血化瘀类中成药应用分析[J].齐齐哈尔医学院学报,2016,37(9):1219-1221.
[4]刘建华.2012年~2014年我院心血管类中成药用药分析[J].首都食品与医药,2016(14):63-66.
[5]曾西北,吴军.四家医疗机构中成药注射剂使用情况分析[J].中成药,2012,34(9):1841-1842.
[6]林建漳,袁祥洪.我院加强药品控费的措施与效果分析[J].海峡药学,2016,28(11):254-256.
[7]瞿敏.临床药师参与住院医保病史监管的情况与分析[J].中国药物经济学,2014,9(4):24-26.
[8]张倩,赵冬,解武祥,等.2007至2012年北京市居民冠心病住院天数及住院费用变化趋势[J].心肺血管病杂志,2016,35(2):75-79.
[9]曹凯,张晓利.药品支付标准之难[J].中国医院院长,2017(12):57-59.