1992—2001年成都市门诊诊疗人次与病人门诊医疗费用负担变动趋势分析  

Changing tendency analysis of clinic diagnose-and-treat person-times and patients' clinic medical treatment cost burden in Chengdu city from 1992 to 2001

作　　者：杨建南[1] 刘勇华[2] 尹代红[3] 辛珏[4] 熊燕[1] 张幼嘉[5] 

机构地区：[1]成都铁路中心医院,四川省成都市1610081 [2]成都市卫生局计财处 [3]成都市第三人民医院 [4]成都市第九人民医院.妇产科医院 [5]成都市第一人民医院

出　　处：《中国医院统计》2007年第2期120-122,共3页Chinese Journal of Hospital Statistics

摘　　要：目的探讨控制门诊医疗费用增长,有效缓解人民群众“看病贵”问题的有效途径。方法对成都市1992—2001年门诊诊疗人次与门诊医疗费用进行分析。结果①平均诊疗人次费用平均每年增长21.03%,平均诊疗人次药费平均每年增长17.36%,平均诊疗人次其他费用每年平均增长23.47%(P值均<0.05)。3项指标的年平均增长幅度均高于成都市同期城镇居民家庭人均现金收入和农村居民人均总收入的年平均增长幅度(15.40%,14.59%)。②门诊诊疗人次呈下降趋势,平均每年递减1.99%(P<0.05)。③门诊诊次与平均诊疗人次费用呈负相关(rs′=-0.7528,P<0.05)。结论对于控制医疗费用增长,政府应考虑改变目前公立医院“以药养医”的补偿机制;对于药品要做到科学合理定价,减少中间环节和强化监督执法。医疗机构要做到合理检查、合理治疗、合理用药、合理收费,防止过度防御性医疗。Objective To discuss how to control the increase with clinic medical treatment cost, and the effective way to alleviate the patients＇ suffering that “medical treatment cost is expensive” in Chengdu city. Methods To analyze the clinic diagnose-and-treat person-times and clinic medical treatment cost in Chengdu city from 1992 to 2001. Results ①Average cost with diagnose-and-treat person-times increased 21.03%, average medical treatment fees increased 17.36% and the other fees increased 23.47% every year （ P 〈0.05 ） . Each increasing degree of three indexes was higher than that of the average family individual cash income of cities-and-towns residents in Chengdu city, and the average individual general income of country residents in the corresponding period （ 15.40%, 14.59% ） . ②The Clinic diagnose-and-treat person-times presented a decreasing tendency, and it decreased 1.99% per year（ P 〈 0.05 ） ,③The clinic examination times and average diagnose-and-treat persontimes cost presented a negative correlation （ rs = - 0. 7528, P 〈 0.05 ） . Conclusion In order to control the excess increase of the medical treatment cost, the government should emphatically consider changing the compensative mechanism in public hospi- tals and the mechanism of “supporting doctors by medicines” from the source. The medicines price should be made scientifically and reasonably, middle links should be decreased, and supervision and enforce-law should be strengthened. Medical organizations should achieve reasonable examining, treating, remedy and charging, and prevent excess defensive medical treatment.

关 键 词：门诊诊疗人次 医疗费用 药品费用 公立医院 补偿机制 

分 类 号：R197.1[医药卫生—卫生事业管理] F763[医药卫生—公共卫生与预防医学]