医药价格综合改革对城市公立医院运营效率的影响  

Influence of Pharmaceutical Pricing Reform on Economic Operating Efficiency of Urban Public Hospitals

作　　者：奚华清 孔凡心 谢静[1] 马爱霞[1] 唐文熙[1] XI Hua-qing;KONG Fan-xin;XIE Jing;et al(School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, Jiangsu, 211198, China)

机构地区：[1]中国药科大学国际医药商学院,江苏南京211198

出　　处：《中国医院管理》2018年第4期15-19,共5页Chinese Hospital Management

基　　金：国家自然科学基金青年基金资助项目(71603278);江苏省教育厅哲学社会科学基金资助项目(2016SJD630007)

摘　　要：目的评估医药价格综合改革对城市公立医院经济运营效率的影响,为城市公立医院价格综合改革的深化及配套措施的完善提出建议。方法采取数据包络分析和Tobit模型,对南京市16家公立医院医药价格综合改革前后12个月的数据进行分析。结果改革后大多数医院医疗服务收入占比显著提升,药占比下降,总体符合价改目的。改革前一年达到效率最优的有8所医院,有3所规模报酬递减,4所规模报酬递增;改革后一年达到效率最优的医院有7所,规模报酬递减2所,规模报酬递增6所;医疗服务所占比例每提高10%,医院效率提高6.19%左右。结论医药价格综合改革提高了运营效率,依收入结构不同有所差异;差异化补偿方案有助于公立医院维持运营平衡;城市公立医院管理应围绕成本进一步精细化发展。Objective To evaluate the influence of pharmaceutical pricing reform on the economic operating efficiency of urban public hospitals in order to provide suggestions for the deepening of pharmaceutical pricing reform and the perfect the supporting measures. Methods Financial data from 16 hospitals 12 months pre-and post-reform were collected. Data development analysis Tobit model was applied. Results After the reform,the proportion of medical service revenue of most hospitals increases significantly,and proportion of drug sales decline significantly. Generally speaking,the reform achieves success. Before the reform,8 hospitals reach optimum efficiency,3 hospitals have decreasing returns to scale,and 4 have increasing returns to scale. After the reform,7 hospitals reach optimum efficiency,2 hospitals have decreasing returns to scale,and 6 have increasing returns to scale. It is found out that if there is 10% increase in medical service proportion,efficiency increases by 6.19% in hospitals. Conclusion Pharmaceutical pricing reform improves the operating efficiency of public hospitals,but the effect varies with the revenue structure;differentiated compensation scheme will help to maintain balanced operating;the management of public hospitals should be refined based on cost.

关 键 词：公立医院 医药价格改革 运营效率 数据包络分析 TOBIT模型 

分 类 号：R197.3[医药卫生—卫生事业管理]