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基于时间序列的按人头支付对门诊医疗费用的影响分析
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Time Series Analysis of Capitation Payment Reform Effect for Outpatient Cost
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    摘要:

    目的:分析按人头支付政策干预对参合对象门诊医疗费用的相关影响。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门诊患者医疗费用相关数据,通过时间序列分析方法,评价政策干预对参合对象门诊医疗费用的影响。结果:政策干预后40个月参合对象的实际次均门诊费用(90.37元)较干预前20个月(84.98元)增加了6.34%;Holt-winters加法模型结果显示,按人头支付政策干预后,次均门诊费用的模型预测值(102.00元)明显高于实际值(P<0.001);同时简单季节模型结果显示,同期参合对象的实际门诊人次与预测值间差值无统计学差异(P>0.05)。结论:按人头支付政策干预3年多来,对控制参合对象次均门诊费用效果显著,在控费的同时未抑制门诊需求的正常释放。

    Abstract:

    Object: To evaluate the effect of outpatient cost under the background of the capitation payment policy intervention in new rural cooperative medical system (NCMS). Methods: We performed retrospective time series analysis of the outpatient cost in NCMS fund by examining monthly data acquired from 2011 to 2015, in Pudong New Area . Results: In 40 months after the intervention, the mean insured outpatient cost per visit (RMB 90.37) was increased by 6.34% than 20 months before (RMB 84.98). The mean forecasted outpatient cost per visit (RMB 102.00) by Winters’ additive models was higher than observed values ( P<0.001). And there was no statistical difference between the observed and forecasted number of insured outpatients of the corresponding period by simple seasonal model (P>0.05). Conclusion: In over 3 years after the c apitation payment reform, it was very effective in controlling insured outpatient cost per visit and d id not inhibit the normal release of service demand.

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舒之群,李明,顾建钧,等.基于时间序列的按人头支付对门诊医疗费用的影响分析[J].中国卫生经济,2017,(7):38-40.基于时间序列的按人头支付对门诊医疗费用的影响分析[J]. CHINESE HEALTH ECONOMICS,2017,(7):38-40.

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