药品零加成前后某医院肿瘤内科胃癌住院患者费用分析  

An analysis on the cost of hospitalized patients with gastric cancer in a hospital before and after the implementation of the policy of “zero-addition of drug costs”

作　　者：崔鑫宇 朱方[1] 谢娟[1] CUI Xinyu;ZHU Fang;XIE Juan(Discipline Inspection Commission Office,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China)

机构地区：[1]四川大学华西医院纪委办公室·监察处

出　　处：《华西医学》2019年第12期1390-1394,共5页West China Medical Journal

基　　金：四川省科学技术厅软科学项目(2019JDR0252);四川大学华西临床医学院/华西医院党建研究课题(HXDJ2019015)

摘　　要：目的比较分析四川省取消药品加成调整方案实施前后住院患者费用变化情况,为了解改革效果并进一步优化方案提供参考。方法从医院信息管理系统中提取2016年1月-9月(实施前)及2017年1月-9月(实施后)两时段某三级综合医院肿瘤内科胃癌住院患者数据,比较四川省取消药品加成调整方案实施前后患者住院相关费用变化情况。结果最终纳入患者2 878例,2016年1月-9月1 453例,2017年1月-9月1 425例。政策实施前后,胃癌患者住院总费用中位数由7 331.31元下降到7 145.12元,下降2.54%;药品费中位数由4 839.79元下降到4 246.10元,下降12.27%;检查检验费中位数由740.00元上升到859.00元,上升16.08%;治疗费中位数由251.00元上升到424.00元,上升68.92%;与政策实施前比较,政策实施后的总费用及药品费用下降,材料费、治疗费、检查检验费及其他费用有所上升(P<0.05);放疗费、介入费在政策实施前后比较,差异均无统计学意义(P>0.05)。结论政策实施后胃癌住院患者费用构成变化,总费用略有降低;通过强化医院内部运营管理,持续优化公立医疗机构医疗服务和收入结构;政府应将补偿机制落实到位,持续完善医疗保险支付方式,最终在提升医务人员的劳务价值的同时保障人民医疗需求。Objective To compare and analyze the expenses of inpatients before and after the implementation of the adjustment plan for "abolition of the addition of drug expenses"(also called zero-addition of drug costs) in Sichuan Province, in order to provide a certain reference for understanding the effect of this reform policy and further optimizing the formulation. Methods From the hospital information management system, the data of inpatients with gastric cancer in a tertiary general hospital in Sichuan Province from January to September 2016(before implementation)and from January to September 2017(after implementation) were collected and compared. The change in hospitalization expenses of relevant patients before and after the implementation of the adjustment plan for canceling the addition of drug expenses was analyzed. Results A total of 2 878 patients were included in the survey;from January to September 2016,1 453 patients were included, and from January to September 2017, 1 425 patients were included. Before and after the implementation of the policy, the median hospitalization expenses of patients with gastric cancer decreased from 7 331.31 yuan to 7 145.12 yuan, with a decrease of 2.54%;the median expenses of medicines decreased from 4 839.79 yuan to 4 246.10 yuan, with an decrease of 12.27%;the median expenses of check and inspections increased from 740.00 yuan to 859.00 yuan, with an increase of 16.08%;the median expenses of treatment increased from 251.00 yuan to 424.00 yuan, with an increase of 68.92%;compared with the total expenses and drug expenses before implementation, the total expenses and drug expenses after implementation decreased significantly, while material expenses, treatment expenses,check and inspection expenses and other expenses increased somewhat(P<0.05);differences in radiotherapy expenses and surgical treatment expenses before and after the implementation of the policy were not statistically significant(P>0.05). Conclusions After the implementation of the policy of "abolition of drug ex

关 键 词：药品零加成 公立医院 胃癌患者 住院费用 

分 类 号：R73[医药卫生—肿瘤]