摘要
[目的]分析四川省公立医院2017-2020年医疗费用结构变动情况,为进一步科学、合理控费提供参考。[方法]利用国家卫生健康统计信息网络直报系统,提取四川省公立医院2017-2020年医疗费用相关数据,包括医疗费用、门诊费用、住院费用、药占比、平均住院日等数据。采用描述性分析方法对2017-2020年四川省公立医院医疗费用相关指标变化情况进行分析,利用结构变动度分析对公立医院门诊次均费用、住院次均费用及各项明细费用的变动情况进行分析。[结果]2017-2020年,四川省公立医院次均门诊费用、次均住院费用的总结构变动度分别为10.19%、10.58%。引起次均门诊费用变动的主要项目是药品费用、检查检验费、治疗费,三者累计贡献率达87.54%;对于次均住院费用而言,药品费用占比变动对次均住院费用变动贡献率最高,为39.32%,检查检验费和卫生材料费,是改革后引起人均住院费用结构变动的另外两个主要费用项目,两者累计贡献率达30.34%。[结论]四川省城市公立医院综合改革全面推开以来,取消药品加成改革政策落地见效,但需对卫生材料费的增长加以重点关注,通过改革联动持续优化费用结构,提升医务人员技术劳务价值,调动内生动力,巩固改革成效。
Objective Analyze the changes of medical expense structure in public hospitals in Sichuan Province from 2017 to 2020 so as to provide reference for further scientifically and reasonably control medical expenses. Methods It made use of national health statistic information direct network report, relevant data of medical expenses in public hospitals in Sichuan Province from 2017 to 2020 including medical expenses, outpatient costs, hospitalization costs, drug proportion and average length of stay, etc. were extracted. The relevant national data came from 2018 to 2020 national health service development statistical bulletins released by the official website of the National Health Commission. Descriptive analysis method was used to analyze the changes of relevant indicators of Sichuan public hospitals’ medical expenses from 2017 to 2020;Analyzed the changes of average outpatient and hospitalization expenses per time, and detailed expenses in public hospitals by structural change degree. Results From 2017 to 2020,the total structural change of the average outpatient and hospitalization in public hospitals in Sichuan Province was 10.19% and 10.58%,respectively. The main items that caused the changes in the average outpatient cost per time were drug costs, treatment costs, check and laboratory examination costs, with a cumulative contribution rate of 87.54%;In terms of the average hospitalization cost per time, the change in drug costs contributed the most to the change in the average hospitalization cost per time(39.32%). Inspection and laboratory examination fees, and sanitary materials fees were the other two major expense items that had caused changes in the structure of hospitalization cost per time after the reform, with a cumulative contribution rate of 30.34%. Conclusions Since the reform of urban public hospitals in Sichuan Province has been fully implemented, the cancellation of the drug mark-up reform policy has been effective, but it is necessary to focus on the increase in the cost of sanitary materials, and continue to optimize the cost structure through joint reform, increase the value of medical staff’s technical labor services, and mobilize internal vitality to consolidate the effectiveness of reforms.
作者
陆婷婷
章舒琦
LU Ting-ting;ZHANG Shu-qi(Suining Central Hospital,Suining Sichuan 629000,China;Health Commission of Sichuan Province,Chengdu Sichuan 610015,China)
出处
《卫生软科学》
2022年第11期52-55,共4页
Soft Science of Health
基金
四川省遂宁市市级科技计划项目基金-四川省遂宁市区域性医疗联合体运行效果的实证研究(2014s31)。
关键词
公立医院
次均费用
结构变动度
public hospital
average expense per time
structural change degree
作者简介
陆婷婷(1983-),女,贵州贵阳人,硕士,主管技师,主要从事医院管理方面的研究。
