取消医用耗材加成对住院费用构成的预测分析  

Prediction of The Influence of Canceling Medical Consumables Addition on Hospitalization Expenses

作　　者：向明飞 罗安心 比确子拉 侯飞 沈薇[2] XIANG Mingfei(Sichuan Cancer Hospital,Chengdu,P.R.China)

机构地区：[1]四川省肿瘤医院.四川省癌症防治中心.电子科技大学医学院,四川成都610041 [2]南方医科大学南方医院

出　　处：《中国卫生事业管理》2019年第8期599-602,共4页Chinese Health Service Management

基　　金：四川省卫生计生委支撑课题(130232)

摘　　要：目的:分析某肿瘤医院根据某省“取消医用耗材加成同步调整医疗服务项目价格”前患者实际费用和调价后费用的差异,评估本次价格调整的合理性,为政府监管医疗服务价格提供参考。方法:把《省管公立医院取消医用耗材加成后调整的医疗服务项目价格表》作为预测价格,统计出院病人收费明细分别和结算价格、预测价格对照,得到患者实际价格与预测价格。从病案统计系统中导出同期出院病人的治疗科室、手术信息。运用SPSS 21.0统计软件进行统计分析。结果:统计期间出院16028人次,依据预测价格计算,医疗总费用增加了3.62万元,人均费用增加2.26元,人均费用波幅没有统计学意义;费用构成上:手术费、一般检查、一般治疗、放射检查、放射治疗增加,卫生材料费下降幅度较大,增幅和降幅具有统计学意义,其他费用构成没有变化;治疗科室上:肿瘤外科人均费用增加,肿瘤内科、肿瘤放疗科人均费用下降,波幅具有统计学意义;手术情况:手术患者人均费用增加,非手术患者减少,波幅有统计学意义。结论:取消医用耗材加成,同步调整医疗服务项目价格对医院总收入影响不大,但是对不同科室医护人员劳动价值的体现不够充分;人均费用虽然没有明显变化,但社保提高了调增医疗服务项目报销比例,降低了病人的自费比例。Objective To comparatively study the patients’medical cost before and after canceling medical consumables addition in one cancer hospital,evaluate the rationality of price adjustment,and provide references for governmental supervision.Methods The price of adjusted list of medical service items after canceling the addition in provincial public hospitals was taken as the forecast price.Patients’treatment department and operation information were obtained from medical record statistics system.Data was analyzed with statistical software of SPSS 21.0.Results During the statistical period,16,028 patients were discharged from hospital.According to the predicted price,the total medical expenses increased by 36,200 RMB Yuan,and the per capita expenses increased by 2.26 Yuan.The per capita expense fluctuation had no significantly differences.As for the cost composition,the cost of operation,examination,treatment,radiological examination and radiotherapy significantly increased,while the health material cost significantly decreased.As for treatment departments,the per capita cost of surgical oncology significantly increased,while that of medical oncology and radiotherapy oncology significantly decreased.As for the operation,the per capita cost of surgical patients significantly increased,while that of non-surgical patients significantly decreased.Conclusion Canceling medical material addition and synchronously adjusting the price of medical service items had no significant influence on the hospital’s total revenue,but they can’t fully reflect the labor value of medical staffs in different departments.There had no significant change in per capita cost,but the reimbursement ratio of the increased medical service items increased in social security system,while the patients’self-expense ratio decreased.

关 键 词：医用材料 医疗费用 医疗补偿 医院管理 

分 类 号：R197[医药卫生—卫生事业管理]