各医疗小组:
2017年医保定额及指标分配以各科室前3年各类医保实际发生数据为基础测算依据。其中,2014-2015年数据占测算数据的50%,2016年数据占测算数据的50%。各科室基础数据如下:
居民医保定额测算基础数据
科室
2014年
2015年
2016年
出院人数
出院费用
呼一
74.67
842,768.78
175.11
2,050,381.06
337.41
4,409,062.47
呼二
62.53
702,429.27
104.03
1,456,222.43
225.56
3,052,835.03
呼三
43.00
478,865.42
110.42
1,402,391.32
223.04
3,068,588.20
结内一
27.04
255,425.26
42.25
629,332.88
104.86
1,374,605.61
结内二
37.98
411,701.78
42.94
408,385.13
124.13
1,436,181.75
结内三
33.39
345,375.28
62.66
702,613.66
202.29
2,168,983.36
结内四
38.75
423,747.50
90.39
881,247.26
200.44
2,123,703.61
结内五
29.80
383,865.20
47.61
510,487.49
122.50
1,593,199.81
结内六
25.17
337,548.63
60.80
856,544.69
127.48
1,620,088.30
肿瘤内科
61.53
690,765.86
134.29
1,965,030.79
248.95
3,545,439.45
介入诊疗病房
13.00
166,030.47
19.80
334,524.37
113.57
1,809,634.75
胸部腔镜微创
258,739.01
23.41
402,304.39
64.28
985,124.87
胸外一组
23.18
369,956.56
33.11
533,392.68
101.11
1,496,203.48
胸外四组
14.89
198,032.04
41.00
479,058.62
96.41
1,359,684.69
胸外二组
21.00
355,487.23
62.97
960,251.71
127.83
2,199,506.36
胸外五组
10.75
201,649.87
46.97
657,880.93
78.30
1,396,657.90
胸外三组
51.00
591,767.16
96.63
1,324,229.44
133.00
1,707,849.83
胸外六组
17.58
236,555.54
26.00
216,537.63
63.00
687,600.74
心内
22.49
364,641.18
29.65
418,077.13
45.64
752,120.76
心外
1.37
17,187.88
10.23
310,477.72
呼吸监护
7.33
172,211.85
8.89
502,135.00
12.57
549,373.25
新结内一
14.01
316,288.25
24.44
650,386.69
52.04
1,162,564.71
新结内二
10.52
191,010.98
26.21
766,437.72
39.38
1,130,860.37
综合内科
54.01
580,428.15
92.86
1,101,775.82
216.58
3,192,518.39
综合外科
40.38
885,637.37
40.19
906,421.03
73.40
1,481,827.85
省直医保定额测算基础数据
52.48
619,859.82
46.31
709,506.63
52.00
817,122.08
29.81
506,545.83
30.20
549,502.64
22.26
322,320.03
24.64
406,537.84
23.00
285,444.29
19.26
269,097.36
10.09
206,091.64
14.03
186,494.70
13.17
157,961.61
10.00
89,180.64
124,199.57
10.17
87,618.69
9.46
113,408.19
222,835.25
255,734.03
13.82
166,406.39
17.48
178,630.82
12.20
114,739.08
15.17
233,643.00
11.63
173,841.71
24.59
314,748.12
10.28
138,073.26
26.16
543,747.85
395,784.38
24.72
410,211.53
20.20
316,123.97
328,249.86
4.00
106,903.19
0.52
10,620.76
7.00
93,687.26
9.00
173,768.07
2.00
24,440.37
23,382.15
17.65
446,079.76
15.00
427,633.90
27.00
495,458.60
6.00
79,643.43
73,387.01
139,297.30
150,783.98
169,662.26
20.00
363,412.65
2.50
33,861.23
8.00
128,224.73
22,075.18
12.00
187,109.00
3.00
46,903.86
1.19
30,867.17
1.00
14,285.53
7,759.74
23.49
562,765.68
39.00
512,825.06
21.24
517,590.68
1.84
84,935.37
6.79
535,271.25
3.46
409,058.74
7.50
1,143,535.46
4.40
98,427.54
23,492.70
3.95
105,076.89
4.43
115,829.47
8.01
226,718.01
3.83
84,878.86
12.43
188,220.96
14.45
454,967.19
76,797.43
23,431.98
7.55
116,785.08
7.64
207,029.10
职工医保统筹总量与人数测算基础数据
医疗小组名称
人数
统筹费用
呼吸内科一
193.69
1,883,333.77
210.58
2,427,175.81
258.34
2,692,903.77
呼吸内科二
157.37
1,475,937.00
165.45
1,640,226.61
159.51
1,717,922.13
呼吸内科三
134.23
1,075,841.90
153.89
1,384,923.65
171.24
1,657,207.64
结核内一
106.11
1,117,928.72
137.71
1,145,430.11
113.51
1,118,696.99
结核内二
94.64
587,911.86
82.37
636,961.78
114.99
1,040,248.08
结核内三
139.67
895,579.71
129.06
973,253.41
181.01
1,329,036.10
结核内四
150.63
1,034,022.66
110.57
964,694.84
170.66
1,343,360.60
结核内五
125.13
969,489.80
95.06
982,929.53
129.14
1,364,721.04
结核内六
109.12
759,827.09
121.64
1,117,290.48
138.83
1,301,336.79
肿瘤内
226.62
2,503,889.01
210.08
2,548,234.97
239.31
2,501,185.04
介入诊疗科
48.70
544,755.95
33.19
407,594.67
89.39
1,016,959.10
277,072.23
32.20
425,137.78
61.70
768,466.66
107.23
1,119,736.43
168.21
2,064,962.91
153.09
1,986,153.81
44.00
415,634.48
55.88
531,993.52
57.94
586,247.52
75.04
1,133,992.57
84.55
1,181,405.58
141.31
1,845,983.62
76.90
981,792.54
77.51
849,599.43
638,162.45
88.00
818,815.19
129.19
1,127,173.90
128.44
1,135,020.31
27.89
313,688.89
59.87
594,131.51
56.85
508,501.08
88.48
1,007,558.22
54.83
582,491.56
48.89
574,992.10
7.11
375,921.96
173,389.42
7.73
111,761.26
16.93
815,296.44
22.77
1,137,046.28
16.13
1,158,974.37
新结核内一
46.95
683,160.16
39.50
782,041.32
47.47
931,417.66
新结核内二
47.85
815,947.73
41.98
881,566.47
44.02
1,146,030.80
综合内
78.41
737,892.07
95.96
973,014.38
126.38
1,676,504.37
综合外
71.50
1,033,973.78
51.95
829,286.34
43.24
862,692.08