补偿机制改革对县医院医疗服务利用情况的影响分析  

Analysis of the Impact of Compensation Mechanism Reform on Medical Service Utilization of County-level Public Hospital

作　　者：常宝松[1] 郭娜 陈丽 吴琼[4] 朱大伟 CHANG Baosong;GUO Na;ZHU Dawei(Institute of Materia Medica,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing, 100050,China)

机构地区：[1]中国医学科学院药物研究所,北京100050 [2]中国人口与发展研究中心,北京100081 [3]Augusta University,GA,30912 [4]中国医学科学院医学信息研究所,北京100020 [5]北京大学中国卫生发展研究中心,北京100191

出　　处：《中国社会医学杂志》2019年第3期299-301,共3页Chinese Journal of Social Medicine

基　　金：中国博士后科学基金会第64批科学基金项目(2018M641126)

摘　　要：目的了解补偿机制改革对县医院医疗服务利用情况的影响。方法以山东省某县级公立医院门诊和住院患者的微观数据为基础,利用多元回归模型以及间断时间序列的分段回归模型,分析补偿机制改革与诊疗费用及服务量之间的关系,评价改革对医疗服务利用情况的影响。结果患者改革后门诊和住院的服务量下降,变化趋势也明显下降。门诊费用提高,住院费用下降,但变化趋势均明显下降。结论补偿机制改革对医疗服务利用的影响积极与消极并存。如何激励医院提供服务、激励患者合理利用服务是下一步改革需要解决的问题之一。Objective To evaluate the impact of compensation mechanism reform on medical service utilization of county-level public hospitals. Methods Based on the outpatient and inpatient micro data as patients'medical information from a county-level hospital in Shandong province,multiple linear regression and interrupted time series segmented regression were employed to analyze the relationship between the reform and medical costs,as well as service volu- me,and to evaluate the impact of the reform on medical service utilization. Results After the compensation mechanism reform,both outpatient and inpatient medical service volumes decreased,and their changing trends all declined obviously.Inpatient expenses decreased but outpatient expenses increased,while their changing trends all declined obviously. Conclusion Both positive and negative effects of the reform on medical service utilization are shown in this study.How to encourage hospitals to provide services and to inspire patients to utilize services rationally is one of the problems that should be solved in the next stage of reform.

关 键 词：补偿机制改革 服务利用 多元回归 间断时间序列 

分 类 号：R197.32[医药卫生—卫生事业管理]