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目的:分析按人头支付政策干预对参合对象住院服务利用的影响。方法:收集2011—2015年浦东新区按人头支付干预前后新型农村合作医疗参合对象住院服务利用相关数据,通过比较分析,评价政策干预对参合对象住院服务利用的影响。结果:超过70%的住院医疗服务利用发生在二三级医疗机构,且政策干预后更加向二三级医疗机构集中;其中二级医疗机构2015年住院人次数占52.58%,住院费用占61%;从环比增速来看,二三级医疗机构次均住院费用增速分别从政策干预前的31.49%和8.58%下降到2015年的3.84%和4.05%。结论:参合对象的总体住院服务利用次数和费用均逐年增加,二级医疗机构住院费用增长趋势明显;政策干预后二三级医院参合对象次均住院费用的增长得到明显遏制。
OBJECTIVE: To analyze the impact of intervention by head-pay policy on the utilization of inpatient services in participating countries. Methods: The data of inpatient service utilization of new rural cooperative medical care participants in Pudong New Area before and after the intervention were collected from 2011 to 2015 in Pudong New Area, and the impact of policy intervention on the utilization of inpatient services in participating countries was evaluated through comparative analysis. Results: More than 70% of inpatient medical service utilization took place in secondary and tertiary medical institutions, and more were concentrated in secondary and tertiary medical institutions after policy intervention. Among them, secondary medical institutions accounted for 52.58% of hospitalizations in 2015 and hospitalization expenses accounted for 61% In terms of growth rate, the average growth rate of hospitalization expenses of second and third tier medical institutions dropped from 31.49% and 8.58% respectively before the policy intervention to 3.84% and 4.05% in 2015 respectively. Conclusions: The number and cost of general inpatient services in participating countries increased year by year, and the growth trend of hospitalization expenses in secondary medical institutions was obvious. The growth of average hospitalization expenses of participating hospitals in secondary and tertiary hospitals was significantly checked after policy intervention.