关键词: 医改政策; 脑梗死; 住院费用; 影响

Abstract:

Objective To make an analysis of the differences in cerebral infarction patients’ hospital cost under different medical reform policies, so as to provide suggestions on making Beijing medical reform policy. Methods Based on relevant theories, the data of cerebral infarction patients’ hospital cost in Beijing Tiantan Hospital, Capital Medical University before and after three successive implementations of medical reform policies in terms of performance assessment, total prepaid amount and separation of Medicare and drug sale in 2012 were collected. The data from three aspects: tendency, necessity and accessibility were analyzed. Rank-sum test and multiple regression analysis in SPSS18.0 were conducted. The regression models were constructed. By using the regression models, the differences in hospital cost under different medical reform stages were compared. Results There was significant difference in the different medical reform stages. In the performance assessment stage, the cost of the patients with medical insurance reduced by11.44%, and that of self-pay patients by 6.91%. In the performance assessment plus total prepaid amount stage, the cost of the patients with medical insurance reduced by 9.51%, and that of self-pay patients increased by 2.88%. In the performance assessment plus total prepaid amount plus separation of Medicare and drug sale stage, the cost of the patients with medical insurance increased by 4.75%, and that of selfpay patients reduced by 25.50%. Conclusion The administrations of the medical reforms should pay attention to the different effects of medical reform on the cerebral infarction patients’ hospital cost, reinforce the supervision of medical organizations, guide reasonable medication, so as to reduce the disease burden of patients with cerebral infarctions.

Key words: Medical reform policy; Cerebral infarction; Hospital cost; Influence Medical reform policy; Cerebral infarction; Hospital cost; Influence