支付方式对白内障日间手术开展的影响研究-《中国卫生质量管理》

文章信息/Info

Keywords:: Average Quota Payment; Payment by Single Disease; Ophthalmology; Cataract; Day-Time Surgery

摘要:: 目的分析不同医保支付方式对开展白内障日间手术的影响。方法从中山眼科中心白内障科实施表面麻醉下白内障摘除及人工晶体植入术的患者中，选取2011年11月平均定额支付患者和2013年11月单病种支付患者的资料，回顾性统计分析患者支付费用、日间手术量及影响因素。结果单病种支付日间手术人次数及比例和医保患者中日间手术人次数及比例都比平均定额支付有了大幅度提升。不论传统住院模式还是日间手术模式，单病种支付方式明显低于平均定额支付，二者差异有统计学意义（P<0.05）。患者支付费用及医保支付方式是影响日间手术的重要因素。结论单病种支付比平均定额支付更有利于促进白内障日间手术的开展。建议探索适宜的支付方式，激励日间手术开展，让日间手术患者享有更优医疗保障，从而推动日间手术健康、稳定发展。

Abstract:: ObjectiveTo analyze the effect of medical insurance payment methods on the day-time surgery of cataract. MethodsAmong the patients with cataract extraction and intraocular lens implantation under topical anesthesia in Zhongshan Ophthalmic Center, the data of the patients with the average quota payment in November 2013 and with the single disease payment in November 2011 were selected. statistical analysis on payment, day-time surgery and its influencing factors of patients were carried out.ResultsThe number and proportion of patients with single disease payment day-time surgery, and the number and proportion of patients among medical insurance had greatly improved than those of patients with the average quota payments. Whether the traditional hospitalization or the day-time surgery mode, the payment of the single disease patients was significantly lower than that of patients with the average quota payment, the difference was statistically significant (P<0.05). Patient's payment and the way of medical insurance payment were important factors affecting the number of day-time surgery.ConclusionSingle disease payment was more conducive to promote the development of day-time cataract surgery than the average quota payment. It was recommended to explore the appropriate payment methods to motivate day-time surgery, so that patients can receive a better health care, thus promoting the development of day-time surgery.