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[目的]评估县级医院临床路径及支付方式试点后腹股沟疝的医疗费用效果。[方法]调取2010年1月～2011年7月项目与对照医院在试点前后的腹股沟疝全部病例,应用倾向得分匹配法和倍差法来评价医疗费用效果。[结果]试点后腹股沟疝住院费用、自付费用、药费和检查费分别降低了1311.64元、733.88元、263.01元和191.64元,且药费和检查费比例分别下降了3.95和3.44个百分点。[结论]临床路径及支付方式改革试点降低了医疗费用,可减轻患者经济负担,节约医疗资源。
[Objective] To evaluate the medical cost effect of inguinal hernia after the trial of county clinical path and payment method. [Methods] All the patients with inguinal hernia before and after the pilot project between January 2010 and July 2011 were recruited. The propensity score matching method and double difference method were used to evaluate the effect of medical costs. [Results] The cost of inpatient hospitalization, out-of-pocket expenses, medical expenses and examination fee decreased by 1311.64 yuan, 733.88 yuan, 263.01 yuan and 191.64 yuan respectively after the trial, and the proportions of medical expenses and inspection fees decreased by 3.95 and 3.44 percentage points respectively. [Conclusion] The trial of clinical pathway and payment reform can reduce medical expenses, reduce the economic burden of patients and save medical resources.