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盘锦开展新农合支付方式改革试点 患者负担减轻 医院收入增加
2017-08-11 10:36:03 中国青年网
本报讯 “按疾病分组支付方式改革,最大的好处是患者不用再担心过度医疗,医生会合理检查、合理用药、合理治疗。同样的疾病,今年住院治疗比以前花费得明显少了。”8月9日,正在盘锦市中心医院办理出院手续的李先生告诉记者。
据统计,今年上半年,盘锦市新农合办对市中心医院进行的按疾病分组支付方式第一次结算显示,该医院今年上半年合理控费结余资金达到24.66万元。盘锦市中心医院妇产院区负责人介绍,从今年上半年结算数据看,该医院妇产科上半年次均费用比去年同期下降了316元,剖宫产率也下降了8%。
如何控制医保资金合理支出,确保基金安全,一直是医改中的难题。盘锦市自2015年起,在县级公立医院逐步推进新农合按疾病分组支付方式改革,目前已收到良好效果。统计数据显示,盘山县人民医院、大洼区第一人民医院和大洼区中医院3个县级公立医院进行支付方式改革后,药占比由43%下降至35%,平均每个县级医院每年节省医药费用44万元,使新农合经办机构、医疗机构和患者三方利益均得到了保障。今年初,盘锦市在全面总结县级公立医院支付方式改革试点经验基础上,进一步扩大试点范围,在市中心医院等市级公立医院推进新农合按疾病分组支付方式改革。
为确保按疾病分组支付方式改革科学有序进行,盘锦市政府印发了《关于在市中心医院开展新农合按疾病分组支付方式改革试点方案的通知》,市卫计委出台了《关于印发市中心医院按疾病分组支付方式考核标准和付费结算标准的通知》等配套文件,改革试点从今年1月1日起执行。市新农合经办机构每月对市中心医院实行预拨基金,根据考核结果与市中心医院进行半年统一结算。
盘锦市新农合办负责人表示,通过在公立医院开展新农合按疾病分组支付方式改革,新农合基金由后付制改为预付制,盘活了医院周转费用。“超支不补,结余归己”的原则,激励了医院参与支付方式改革的积极性,不仅减轻了参合患者的医药费用负担,同时还增加了医院自身收入,减轻了经办机构督查的工作压力,让城市新农合基金的使用更加合理。□黄世盛/杨继承/本报记者/刘立杉
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