概括
未来的支付系统对医院的财务状况产生了重大影响,特别是对医疗保险患者. 医院在这些制度下面面临着巨大的损失,原因是补偿金减少和成本增加.
科学领域:
- 卫生经济学 卫生经济学
- 医院财务管理 医院财务管理
- 医疗保健政策 医疗保健政策
背景情况:
- 未来的支付系统 (PPS) 旨在控制医疗保健成本.
- 诊断相关小组 (DRG) 是PPS的一个关键组成部分.
- 紧急诊所是医院入院的关键入口.
研究的目的:
- 评估PPS下的急诊室入院的财务表现.
- 为了比较医疗保险和全付费系统之间的财务结果.
- 分析特定的PPS调整对医院收入的影响.
主要方法:
- 对1983年和1984年急诊室住院费用和费用进行分析.
- 应用标准的诊断相关小组 (DRG) 方法.
- 医疗保险和全付费系统下的财务数据的比较.
主要成果:
- 在这两种支付系统中,医院在使用费用作为费用指标时遭受了重大财务损失.
- 使用实际成本,医疗保险患者导致赤字,而全付费系统显示了很小的利.
- 联邦化的DRG费率和异常/教学成本补偿的削减加剧了财务损失.
结论:
- 医院急诊室入院量较高的医院,特别是医疗保险患者,在PPS下面临经济不利.
- 公共卫生服务机构的报销结构可能无法充分支付与紧急部门驱动的入院相关的成本.
- 需要对PPS进行政策调整,以确保为服务于大量医疗保险人口的医院提供财务可行性.
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