完善印度政府资助的医疗保险计划的提供者支付系统:经济学分析
Shankar Prinja1, Pankaj Bahuguna2,3, Maninder Pal Singh2,4
1Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India shankarprinja@gmail.com.
这项研究量化了医院位置和教学地位等因素如何影响印度Ayushman BharatPradhan Mantri Jan Arogya Yojana (PM-JAY) 保险计划的成本. 调查结果支持差异性报销率来解释这些成本变化.
科学领域:
- 卫生经济学 卫生经济学
- 医疗保健的融资 医疗保健的融资
- 医疗保健服务研究 医疗服务研究
背景情况:
- 国家医疗保险计划经常使用加权的报销率来反映服务提供成本.
- 印度的Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) 是一个由公共资助的国家医疗保险计划.
- 确定准确的权重对于公平有效的基于案例的支付系统至关重要.
研究的目的:
- 为了确定PM-JAY的差异化基于案例的支付系统的权重.
- 探索和量化供给侧因素对住院和手术程序成本的影响.
- 为了解决PM-JAY的差价计划的调整.
主要方法:
- 使用基于回归的成本函数分析.
- 数据来源于印度多站点医疗服务成本研究 (CHSI).
- 该分析包括印度11个州的公立和私立医院,包括57个设施.
主要成果:
- 教学地位和医院位置显著影响了住院病人的住院费用和外科手术费用.
- 与非教学医院和3级城市相比,教学医院和1级1/2级城市的医院每次住院和每次手术的费用要高得多.
- 估计的平均成本为每位住院患者每天2307卢比,每次手术10686卢比.
结论:
- 研究结果验证了PM-JAY的差异性供应商支付系统.
- 承认医院成本因位置和教学地位等因素而异.
- 建议考虑对覆盖范围,质量和未来计划修订的激励措施的更广泛影响.
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