Analysis of a specialized hospital actual out-of-pocket costs for inpatients based on per diem and fee-for-service payments
10.3969/j.issn.1008-9691.2024.04.017
- VernacularTitle:某专科医院住院患者按床日付费与按项目付费实际自负情况分析
- Author:
Gang SHI
1
;
Xiaohong WANG
Author Information
1. 天津市安定医院院长办公室,天津 300074
- Keywords:
Mental illness;
Pay-per-bed;
Hospitalization expense;
Personal responsibility rate
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2024;31(4):469-472
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the changes in patients'self funded expenses before and after the implementation of the bed day payment policy for hospitalized patients,evaluate the effectiveness of the bed day payment policy implementation.Methods Hospitalization data for insured patients at a specialized hospital were collected from January 1,2021 to December 31,2023,using the hospital information system(HIS).Based on the implementation of the hospital's bed day payment policy,the patients were divided into a pre-implementation pay-per-item group(January 1,2021 to September 30,2022)and a post-implementation pay-per-bed group(October 1,2022 to December 31,2023).The analysis focused on the changes in personal responsibility rate before and after the new policy and across different insurance types.Results The final statistics cover a total of 6 479 pay-per-itemt cases[4 767 with urban employee medical insurance(urban occupational medical insurance)and 1 712 with urban and rural resident medical insurance(urban residential medical insurance)]and 7 743 pay-per-bed cases(5 679 with urban occupational medical insurance and 2 064 with urban residential medical insurance).Compared with pre-implementation pay-per-item group,some patients did not need to pay any out of pocket expenses in certain situations after the implementation of the new policy,the average personal responsibility rate of hospitalized patients in the post-implementation pay-per-bed group decreased from(18.04±12.18)%to(15.14±12.45)%,with an average decrease of 2.90%;the average personal responsibility rate of urban employee medical insurance patients has decreased from(15.65±9.77)%to(12.58±8.91)%,with an average decrease of 3.07%.The average personal responsibility rate of urban residentia medical insurance patients decreased from(24.72±15.34)%to(22.18±17.21)%,with an average decrease of 2.54%.Conclusion After the implementation of the new policy,designated medical institutions have basically achieved reasonable control over the growth of medical expenses,improved the level of patient benefits,reduced the burden of medical treatment on patients,and also promoted the active control of actual cost burden by designated medical institutions.
