安宁疗护按床日付费政策的医保费用特征与区域优化建议OA

Objective To explore the characteristics of medical insurance costs for palliative care in the Panxi region of Sichuan Province under the per-bed-day payment policy.Methods A multicenter retrospective cohort study was conducted,involving oncology patients from five hospitals within a regional medical alliance be-tween August 2022 and August 2024.Participants were grouped based on types of diseases and whether they re-ceived palliative care.Propensity score matching was used to compare medical costs,and conditional logistic re-gression was employed to analyze cost-influencing factors.Results Eighty-six matched pairs(43 per group)were successfully analyzed.The palliative care group exhibited lower total costs,total medication expenses,Western drug costs,and examination fees compared to the non-palliative care group,with most patients being covered by Panzhihua's municipal medical insurance.Receipt of palliative care and length of hospital stay were identified as significant factors influencing costs(P＜0.05).Conclusions The per-bed-day payment policy reduces medical expenses for end-stage patients,yet healthcare institutions face cost pressures.It is recommended that regional op-timization measures be implemented to promote the sustainable development of palliative care.