摘要
目的:分析北京市医药分开和医耗联动综合改革前后冠心病患者住院费用的变化情况,探讨政策实施的效果以及存在的问题。方法:从北京市医价平台获取66647例冠心病住院患者数据,利用间断时间序列(ITSA)的分段回归模型对医改前、医药分开、医耗联动三个阶段冠心病患者平均住院费用、医疗费用、药品费用和耗材费用进行分析。结果:阶段性结果显示,三个阶段冠心病患者的平均住院总费用保持稳定,其中,医疗费用占比上升,药品和耗材费用占比下降。间断时间序列(ITSA)结果显示,平均住院总费用、检查费、化验费、药品费和高值耗材费在短期下降后有回升趋势。结论:两轮综合医改后,北京市冠心病住院费用总量得到有效控制,内部构成得以优化,医务人员技术劳动价值逐步体现,整体上与医改原则相符。建议进一步加大检查和化验项目的控制力度,持续加强对药品和耗材的管控,合理规范医疗行为,从而有效控制冠心病患者住院费用。
Objective:To analyze the changes in the hospitalization expenses of patients with coronary heart disease before and after the comprehensive reform of separation of medicines and medical consumption in Beijing,and discuss the effects of policy implementation and existing problems.Methods:The data of 66647 inpatients with coronary heart disease were obtained from the Beijing Medical Price Platform,and the segmented regression model of the Interrupted Time Series Analysis(ITSA)was used to calculate the average expenses,medical expenses,drug expenses and consumable expenses of inpatients with coronary heart disease in the three stages of pre-medical reform,separation of medicines and linkage of medical consumption.Results:The phased results showed that the average total hospitalization expenses of patients with coronary heart disease in the three stages remained stable.Among them,the proportion of medical expenses increased,and the proportion of medicines and consumables decreased.ITSA results showed that the average total hospitalization expenses,inspection fees,laboratory test fees,drug fees,and high-value consumables fees have a tendency to rise after a short-term decline.Conclusion:After the two comprehensive medical reforms,the total amount of hospitalization expenses for coronary heart disease in Beijing has been effectively controlled,the internal composition has been optimized,and the value of the technical labor of medical staff has gradually manifested,which is in line with the principles of the medical reform as a whole.It is recommended to further increase the control of inspection and laboratory items,continue to strengthen the control of drugs and consumables,and reasonably standardize medical behaviors,so as to effectively control the hospitalization expenses of patients with coronary heart disease.
作者
徐阅
刘黎明
程薇
XU Yue;LIU Li-ming;CHENG Wei(Beijing University of Chinese Medicine,Beijing,100029,China;不详)
出处
《中国卫生经济》
北大核心
2021年第9期53-57,共5页
Chinese Health Economics
基金
北京市卫生健康委员会资助项目(2019年度北京市卫生总费用核算)。
关键词
冠状动脉粥样硬化性心脏病
住院费用
间断时间序列
医药分开
医耗联动
北京
coronary heart disease
hospitalization expense
interrupted time series
medical separation
medical expenditure linkage
Beijing
作者简介
徐阅(1992-),女,博士在读,研究方向:卫生经济,E-mail:763110929@qq.com;通信作者:程薇,E-mail:cwei214@vip.sina.com。
