广东省取消药品、耗材加成政策效果研究系列之一:患者疾病负担影响研究  

Series one-Study on the impact of patients disease burden after canceling drugs and consumables price addition in Guangdong Province

作　　者：邱恒[1,2,3] 朱宏 邹俐爱 姚奕婷[1,3] 张远妮[1,3] 邓光璞 宋喜国[3,4] QIU Heng;ZHU Hong;ZOU Li-ai;YAO Yi-ting;ZHANG Yuan-ni;DENG Guang-pu;SONG Xi-guo(Nanfang Hospital,Southern Medical University,Guangzhou Guangdong 510515,China;School of Public Health,Southern Medical University,Guangzhou Guangdong 510515,China;Institute of Health Management,Southern Medical University,Guangzhou Guangdong 510515,China;Zhujiang Hospital of Southern Medical University,Guangzhou Guangdong 510515,China)

机构地区：[1]南方医科大学南方医院,广东广州510515 [2]南方医科大学公共卫生学院,广东广州510515 [3]南方医科大学卫生与健康管理研究院,广东广州510515 [4]南方医科大学珠江医院,广东广州510515

出　　处：《卫生软科学》2020年第7期8-13,共6页Soft Science of Health

基　　金：广东省卫生经济学会2019年科研项目:广州市公立医院取消耗材加成政策效果评价(2019-WJMZ-11)。

摘　　要：[目的]分析广东省医疗服务价格改革对患者疾病负担的影响,为政策动态调整提供决策参考。[方法]采用描述性统计分析、t检验分析评价广东省516家医院2018年上半年和2019年上半年各项费用的变动情况。[结果]与2018年上半年相比,2019年上半年广东省公立医院医疗收入、次均门诊费用、次均门诊技术劳务费、次均住院费用、次均住院技术劳务费差异有统计学意义(P<0.01);职工和城乡居民医保患者次均住院费、省内异地职工医保患者次均住院费差异有统计学意义(P<0.01),广州市省内异地和本地职工医保住院患者次均自负医疗费差异有统计学意义(P<0.01)。[结论]改革后,患者医疗费用支出结构有所优化,医保患者疾病负担总体平稳,医疗收入增长较快,省内异地医保患者负担较高。建议继续深化医疗服务价格改革,规范诊疗行为,进一步控制医疗费用不合理增长。Objective To provide decision reference for policy dynamic adjustment by analyzing the impact of medical service price reform on patients disease burden in Guangdong Province.Methods Descriptive statistical analysis and t-test analysis were used to evaluate the changes in various expenses of 516 hospitals in Guangdong Province in the first half of 2018 and the first half of 2019.Results Compared with the same period of 2018,in the first half of 2019,there was statistically significant differences in medical income,average per outpatient fee,average per outpatient fee of technical service,average per inpatient fee and technical service in Guangdong Province(P<0.01).There was statistically significant difference in the average per inpatient fee of employees and urban and rural residents with medical insurance,and remote employees in the province as well(P<0.01).There was statistically significant difference in the average per inpatient self-financing fee of local or remote employees with medical insurance in Guangzhou(P<0.01).Conclusions After the reform,the structure of patients medical expenses has been optimized.The overall disease burden of medical insurance patients is stable,medical income is growing rapidly.The burden of remote medical insurance patients in the province is higher.It is recommended that we should continue to deepen the reform of medical service prices,regulate the behavior of diagnosis and treatment,and further control the unreasonable increase of medical expenses.

关 键 词：广东省 公立医院 患者疾病负担 医疗服务价格改革 

分 类 号：R197.3[医药卫生—卫生事业管理]