关于印度全民健康覆盖计划的研究 - - 私立医院的脚石
K Ravi Babu1, J Lakshmi Prasad2, N Lakshmi Bhaskar3
1Department of Hospital Administration, Vydehi Institute of Medical Sciences & Research, Bangalore, India.
政府的医疗保险计划,如Ayushman Bharat (AB) 补偿私立医院的费用远低于患者护理的实际费用. 这种财政缺口,特别是复杂的程序,影响私人学术医疗机构的可持续性.
科学领域:
- 卫生经济学 卫生经济学
- 医疗保健政策 医疗保健政策
- 医院管理局 医院管理局
背景情况:
- 政府实施医疗保险计划,以保护弱势群体免受高昂的医疗费用.
- 私立医院是印度二级和三级护理服务的关键提供者.
- 私立医院依靠以前经营的收入来资助基础设施和人员.
研究的目的:
- 为了比较私立医学院医院收到的由政府保险计划覆盖的患者的财政补偿与自我支付的患者.
- 分析私人医疗保健提供者政府医疗保险计划的经济可行性.
主要方法:
- 进行了一项观察性研究.
- 在Ayushman Bharat (AB) 计划下的前十项手术的退款金额与在类似的医院病床上向私人付费患者收取的价格进行了比较.
- 费用包括外科医生的费用,药物,设备和住院费用.
主要成果:
- 根据阿育曼印度 (AB) 计划,私人医院只能偿还26-52%的实际费用.
- 腹腔镜手术等手术造成130%的损失,膝关节置换损失50%,冠状动脉旁路移植损失10%.
- 每月平均有600名患者通过AB计划获得护理,在心血管,癌症和传染病治疗中使用率很高.
结论:
- 私立学术医院在各种程序中需要比目前的报销率增加25%至50%的资金来支付费用.
- 参与政府保险计划的私立医院的财务可持续性受到成本和补偿之间的巨大差距的威胁.
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