| 慢性病按总额支付方式对医联体预防激励的影响 |
| The influence of payment by total amount of chronic disease on the prevention incentive of medical association |
| 摘要点击 242 全文点击 0 投稿时间：2020-06-30 修订日期：2021-11-08 |
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| 中文关键词 社区医院预防努力；三级医院治疗努力；按服务项目支付方式；按总额支付方式 |
| 英文关键词 community hospital prevention efforts; tertiary hospital treatment efforts; payment by service item; payment by total amount |
| 基金项目 智能健康信息服务管理（71531004） |
| 作者 | 单位 | 邮编 | | 潘世富 | 东南大学 | 211189 | | 王海燕* | 东南大学 | 211189 | | 林徐勋 | 常州大学 | |
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| 中文摘要 |
| 针对患者在就医过程中支付方式和医院的选择不同，按总额支付方式对医院预防努力的激励作用，建立了医联体成本最小化模型，计算和比较了社区医院最优预防努力、三级医院最优治疗努力和患者最小成本. 结果表明，当医联体的边际收益率较低时，患者发生并发症后选择医联体内治疗时社区医院预防努力、三级医院治疗努力都比选择医联体外治疗时大. 从患者健康角度考虑，患者发生并发症后医联体将引导患者选择在医联体内治疗. |
| 英文摘要 |
| For the different choices of the payment modes and the hospital in the patients’ process of the medical treatment, this paper studies the incentive effect of bundled payment on hospital prevention efforts. This study build optimization models aimed at minimizing costs of medical association, and calculate and compare the optimal prevention efforts of community hospital, the optimal treatment efforts of the tertiary hospital and the minimum costs of patient. The results show that when the marginal rate of the medical association is low, the prevention efforts of the community hospital and the treatment efforts of the tertiary hospital are greater than the patient is treated the tertiary hospital outside the medical association. From the perspective of patient health, the medical association guides patient to choose treatment in medical association when the patient has complications. |
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