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得克萨斯州一家医院不得不勾消一位病人的165,000美元的巨额帐单。这是老年医疗保险预付制度的最大一次损失。这一情况引起了美国医院联合会的注意,并打算用这个事件向老年医疗保险制度管理人员说明预付制度的种种弊端。一名71岁的老人因自杀入院。当时他左腹上1/4处有枪伤(未击中心脏),入院后即行脾切除术,从而证实患者的主要诊断是在预付制度的按诊断分类定额报销制度的范围之内。患者接受手术达5次以上,住院71天,直至死于肺炎。这家非营利性医院拥有297张病床。院长最初估计该患者的费用大约为140,000美元。而医院管理员估计老年医疗保险制度将补偿16,000—25,000美元。但保健财政管理计划的
A hospital in Texas had to get rid of a patient’s huge bill of $165,000. This is the biggest loss in the prepaid system for medical insurance for the elderly. This situation has attracted the attention of the U.S. Hospital Confederation and intends to use this incident to explain to senior medical insurance administrators the various drawbacks of the prepayment system. A 71-year-old man was admitted to hospital because of suicide. At the time, he suffered a gunshot wound (not hitting the heart) in one-quarter of his left abdomen, and splenectomy was performed after admission. This confirmed that the patient’s main diagnosis was within the scope of the pre-payment system for the reimbursement of the diagnostic reimbursement system. The patient received surgery more than 5 times and was hospitalized for 71 days until he died of pneumonia. This non-profit hospital has 297 beds. The dean initially estimated the patient’s cost to be approximately $140,000. The hospital administrator estimates that the senior medical insurance system will compensate between 16,000 and 25,000 U.S. dollars. But health care financial management plan