补偿机制改革对山东省某县级公立医院住院服务的影响  

Influence of compensation mechanism reform on the hospitalization expenses of a county-level public hospital in Shandong Province

作　　者：姜小峰 姚静静[1] 朱大伟 何平 石学峰 孟庆跃[3] JIANG Xiaofeng;YAO Jingjing;ZHU Dawei;HE Ping;SHI Xuefeng;MENG Qingyue(School of Health Care Management,Shandong University,NHC Key Lab of Health Economics and Policy Research(Shandong University),Jinan 250012,Shandong,China;Qilu Hospital of Shandong University,Jinan 250012,Shandong,China;China Center for Health Development Studies,Peking University,Beijing 100020,China;School of Management,Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]山东大学医药卫生管理学院,国家卫健委卫生经济与政策研究重点实验室,山东济南250012 [2]山东大学齐鲁医院,山东济南250012 [3]北京大学中国卫生发展研究中心,北京100020 [4]北京中医药大学管理学院,北京100029

出　　处：《山东大学学报（医学版）》2020年第9期95-102,共8页Journal of Shandong University:Health Sciences

摘　　要：目的分析补偿机制改革对县级公立医院住院患者住院服务的影响,为进一步完善补偿机制改革提供建议和依据。方法选择糖尿病、肺炎、阑尾炎和腰间盘突出4类常见疾病,运用间断时间序列的分段回归模型,分析山东省某县级公立医院住院患者的住院费用、住院天数和手术率在2014年10月1日改革前后的即时变化和趋势变化。结果补偿机制改革后,该县级公立医院住院患者的次均住院药品费用和医疗服务费用变化有统计学意义;住院患者次均住院总费用、耗材费用、诊断费用变化无统计学意义;住院天数和手术率变化无统计学意义。结论尽管补偿机制改革降低了住院患者的药品费用,但尚未能有效抑制住院患者住院总费用的快速上涨及其他指标变化。Objective To analyze the impact of compensation mechanism reform on the per-visit inpatient services in a county-level public hospital in Shandong Province, and offer evidence for further development and adjustment of the reform. Methods Interrupted time series segmented regression model was used to analyze the instant change which took place on October 1, 2014 and trend of per-visit inpatient expense, hospital stay and surgical rate, based on data of diabetes, pneumonia, appendicitis and lumbar discherniation collected from a county-level public hospital in Shandong Province. Results After the reform, there were statistically significant in the changes of inpatient drug expense and medical service expense in this hospital;there were no statistical significance in the changes of per-visit inpatient expense, medical consumables expense and diagnosis expense;there were no statistical significance in the changes of hospital stay and surgical rate. Conclusion Although compensation mechanism reform reduces the per-visit inpatient drug expense, the trend of rising inpatient expense and other indicators have not been effectively controlled.

关 键 词：补偿机制改革 县级公立医院 住院费用 间断时间序列 分段线性回归 

分 类 号：R197.1[医药卫生—卫生事业管理]