基于灰色关联和结构变动度的山东省公立医院门诊费用分析  

Analysis on outpatient cost of public hospitals in Shandong province based on grey correlation and structural change degree

作　　者：戴涛明 宋奎勐[2] 甄天民[2] DAI Tao-ming;SONG Kui-meng;ZHEN Tian-min(School of Medicine and Life Sciences,Shandong Medical Sciences Academy of Jinan University,Jinan Shangdong 250200,China;Shandong Institute of Medicine and Health Information/Shandong First Medical University&Shandong Academy of Medical Sciences,Jinan Shangdong 250062,China)

机构地区：[1]济南大学山东省医学科学院医学与生命科学学院,山东济南250200 [2]山东省医药卫生科技信息研究所/山东省第一医科大学(山东省医学科学院),山东济南250062

出　　处：《卫生软科学》2020年第9期56-61,共6页Soft Science of Health

摘　　要：[目的]探讨山东省公立医院门诊费用的变化趋势,分析导致公立医院门诊费用变动的主要项目,结合公立医院改革的相关政策提出政策建议,为促进山东省公立医院改革提供参考依据。[方法]收集2012-2016年山东省公立医院门诊次均费用数据,采用灰色关联分析法和结构变动分析法分析其内部的结构变化以及相互之间的关联程度。[结果]山东省公立医院门诊费用逐年增加,年均增长率为2.01%。从灰色关联性来看,检查费是关联性最大的项目,关联度为0.980;从结构变动分析来看,药品费是引起门诊次均费用结构变动的主要项目,结构贡献率为43.010%。[结论]与二级公立医院相比,一级医院与三级医院的门诊费用结构变动更加显著,山东省公立医院药品费用得到了较好的控制,但门诊费用中体现医务人员劳动力价值的费用增幅不明显;建议加强山东省二级医院改革力度,进一步优化门诊医疗费用结构,提高医务人员医疗技术服务定价。Objective To explore the structure variation trend and analyze major influencing items of outpatient cost of public hospitals in Shandong province which combine with relevant policies of public hospital reform and put forward policy suggestions,so as to provide reference basis for promoting reform of public hospitals in Shandong province.Methods Per average outpatient cost data of public hospitals in Shandong province from 2012 to 2016 was collected.Grey correlation analysis and structure change degree analysis were used to analyze internal structure changes and association degree between each other.Results Outpatient cost of public hospitals in Shandong province increased year by year which average annual growth rate was 2.01%.From the perspective of grey correlation analysis,examination fee was the biggest item of correlation,correlation degree was 0.980.From the perspective of structure change,drug cost was main item of causing structural changes in per average cost of outpatient,structural contribution rate was 43.010%.Conclusions Compared with second-class hospitals,the structural changes of outpatient expenses in third-class hospitals and first-class hospitals are more significant.Drug costs of public hospitals in Shandong province have been well controlled.The cost increase of items reflecting the value of labor force is not obvious.It is suggested to intensify reforms of public secondary-level hospitals in Shandong province,further optimize the structure of medical expense and improve the cost reflecting the value of medical workers.

关 键 词：公立医院 门诊费用 灰色关联分析 结构变动度 

分 类 号：R197[医药卫生—卫生事业管理]