Medical charges are the medical income of hospitals, which can be divided into medical service income, inspection income, drug income, sanitary materials income and so on. According to the performance appraisal method of public hospitals, the calculation formula of medical service income ratio is:
Proportion of medical service income = medical service income/medical income * 100%
(1) molecule: medical service income includes registration income, bed income, examination income, treatment income, operation income, pharmaceutical service income and nursing income. Except for drugs, consumables and inspection income.
(2) Denominator: Medical income refers to the income obtained from medical service activities in hospitals, including outpatient income and hospitalization income. The classification of medical income is consistent with the hospital financial system.
This indicator is an important indicator reflecting the hospital income structure. With the improvement of this index, the proportion of medicinal materials and inspection has generally declined, which reflects the rationality of medical service prices from the side. DRG payment affects the "tickets" of hospitals, and DRG empowers hospitals to increase the proportion of medical service income, mainly in three ways.
First, discipline construction is a "guarantee". In order to pay for DRG, hospitals need to strengthen discipline construction, locate specialties, evaluate work efficiency and evaluate medical quality. Discipline construction is the "guarantee" to increase the proportion of medical service income. Therefore, the hospital should focus on positioning the discipline construction strategy, innovate the discipline construction mechanism, improve the discipline performance evaluation mechanism through DRG, encourage discipline construction with performance, and lay the foundation for increasing the proportion of medical service income.
Second, the improvement of medical service ability is the "foundation". The income base of medical service is medical service project. In order to increase the proportion of medical service income, hospitals need to strive to expand medical service projects, improve the management concept of all staff, distribute the price list of medical charges in various departments, study and analyze the medical service capabilities of their own hospitals and departments, and carry out new projects and high-tech and high-risk medical service projects through performance incentives to increase the proportion of medical service income.
Third, the structural adjustment of diseases is the "core". The adjustment of disease structure is the "core" of income structure adjustment. Therefore, it is necessary to understand the disease spectrum of hospitals and departments, analyze the disease structure, find out the dominant diseases with higher medical service income, analyze the diseases with lower medical service income, strengthen performance guidance, and effectively increase the proportion of medical service income.
In short, DRG payment is forced. In addition, the proportion of medical service income is included in the performance appraisal index of public hospitals, which will also affect the national examination results of hospitals. Hospitals need to pay more attention, play the role of internal performance baton while borrowing external forces, increase the incentive of medical service income items, and promote the improvement of hospital medical service capacity. 1 The coincidence rate of admission and discharge diagnosis is ≥95%.
2 The coincidence rate of outpatient and discharge diagnosis