过皓

摘要：目的：探索开展日间手术按病种收付费的临床应用效果和价值。方法：通过回顾无锡市某三甲医院一年多来开展日间手术按病种收付费实践，选择老年性白内障超声乳化摘除术和腹腔镜胆囊切除术等病种与非日间手术进行平均住院数、人均住院费用、人均个人负担、人均医保基金支付等方面比较。结果：日间手术按病种收付费患者平均住院天数明显缩短，人均住院费用明显下降，病人个人负担明显减轻，医保基金明显节约。结论：日间手术按病种收付费可明显缩短住院天数、减少人均住院费用、减轻病人负担、提高医保基金使用效率。

Abstract： Purpose： Explore clinical application effect and value of conducting daytime surgery collected and paid according to diseases. Method： The average number of hospitalizations， per capita hospitalization costs， per capita personal burden， and per capita health care fund payments were compared between the patients with senile cataract phacoemulsification as well as laparoscopic cholecystectomy and non-day surgery by reviewing conducted daytime surgery based on diseases collection and payment in a top three hospital in Wuxi City for more than a year. Outcome： The average length of hospital stay was significantly reduced， the per capita hospitalization expenses decreased significantly， the individual burden of the patients was significantly reduced， and the medical insurance fund was obviously saved. Conclusion： Daytime surgery according to diseases collection and payment can significantly reduce the number of hospital days， reduce per capita hospital costs， reduce the burden on patients， improve the efficiency of health care fund use.

关键词：日间手术；病种收付费；平均住院天数；病人负担；医保基金

Key words： daytime surgery；diseases collection and payment；average number of hospitalization；burden on patients；health care fund

中图分类号：R197.3 文献标识码：A 文章编号：1006-4311（2018）27-0033-02

0 引言

日间手术又称非住院手术，作为一种新型的手术治疗模式，近年来受到广泛关注。2015年，江苏省卫计委联合人社、物价等部门下发文件，对老年性白内障等20个病种实施日间手术按病种收付费。此举被认为是国内日间手术支付方式改革的“典范路径”。无锡市某三级甲等综合性医院于2015年11月13日起率先在无锡市推出首个日间手术病房，对20个日间手术按病种收付费进行试点，截止至2017年6月30日已开展日间手术3600例。日间手术按病种收付费对缩短平均住院天数，降低平均住院费用，减轻了病人个人负担，缓解看病难、看病贵的问题，以及提高医保基金使用效率，取得了一定的成效。

1 日间手术……