受伤病人地区登记的工作模式:信息二。在医院为受伤病人提供医疗服务的医疗和经济问题

A. I. Makhnovskiy, O. N. Ergashev, K. N. Zvonik, V. V. Stozharov, A. Miroshnichenko, I. S. Kochoyan, E. K. Nikitina
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摘要

导言。通过医学和经济分析,可以评估医疗机构的有效性,并为优化其活动的管理决策提供依据。研究目的:对圣彼得堡医疗机构为住院伤病员提供医疗服务的活动进行医疗和经济分析。材料与方法:根据地区强制医疗保险基金的数据,对 2015 年 1 月 1 日至 2023 年 12 月 31 日期间的受伤患者(ICD-10 代码:S00.0-T09.9)进行了登记,登记人数为 1269235 人。对成人和儿童强制医疗保险费率应用的特殊性进行了研究:第一组包括从急诊科(急诊住院部)出院的患者,第二组包括入院但未在重症监护室接受治疗的患者,第三组包括在重症监护室接受治疗的患者。研究结果在规定时间内,圣彼得堡受伤病人的住院医疗护理病例数有所减少:成人病人减少了 32.5%,儿童病人减少了 50.3%;减少的原因是第一组病人数量减少。与此同时,在急诊病床上接受治疗的第一组患者(未在医院各科室住院)的比例有所上升:成人患者的比例上升至 65.1%,儿童患者的比例上升至 20.1%。用于支付成人患者医疗费用的强制医疗保险费用增加了 66.9%,达到 1999 300 000 卢布;用于支付儿童患者医疗费用的强制医疗保险费用增加了 71.0%,达到 575 600 000 卢布。
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The working model of the regional register of patients with injuries: message two. Medical and economic aspects of providing medical care to patients with injuries in hospitals
Introduction. Medical and economic analysis makes it possible to evaluate the effectiveness of medical organizations and justify management decisions to optimize their activities. The purpose of the study: to conduct a medical and economic analysis of the activities of medical organizations in St. Petersburg in providing medical care to patients with injuries in inpatient settings. Materials and methods: according to the data of the Territorial Compulsory Medical Insurance Fund, a patient register has been formed with injuries (ICD-10 codes: S00.0–T09.9) for the period 01.01.2015–31.12.2023, n=1269235. The peculiarities of the application of compulsory health insurance tariffs for adults and children have been studied: The 1st group consisted of patients discharged from the emergency department (inpatient emergency department), the 2nd group consisted of patients admitted to the hospital and not treated in the intensive care unit, the 3rd group consisted of patients treated in the intensive care unit. The results of the study. During the specified period, the number of cases of inpatient medical care for patients with injuries in St. Petersburg decreased: among adult patients — by 32.5%, among children — by 50.3%; the decrease was due to a decrease in the number of patients of the 1st group. At the same time, the proportion of 1st group patients who received medical care in emergency beds (without hospitalization in hospital departments) increased: among adult patients to 65.1%, among children — to 20.1%. The cost of compulsory medical insurance to pay for medical care for adult patients increased by 66.9% to 1999.3 thousand rubles; the cost of paying for medical care for children increased by 71.0% to 575.6 thousand rubles.
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