新医改以来我国各省份医院门诊、住院费用空间相关性研究  

Study on the Spatial Correlation of Outpatient and Inpatient Expenses in 31 Provinces of China since the New Medical Reform

作　　者：陈苗苗 李秉航 马迪 马安宁[1,2] 王春平 高倩倩[1,2] 蔡伟芹 CHEN Miao-miao;LI Bing-hang;MA Di(Weifang Medical University,Weifang,Shandong,261053,China;不详)

机构地区：[1]潍坊医学院,山东潍坊261053 [2]“健康山东”重大社会风险预测与治理协同创新中心,山东潍坊261053

出　　处：《中国卫生经济》2021年第3期18-20,共3页Chinese Health Economics

基　　金：国家自然科学基金项目(71673202);山东省重点研发计划(软科学项目)重大项目(2020RZB14001);山东省社会科学规划研究项目(20CCXJ30);潍坊医学院“应急管理体系规划”项目(2020YJXM06)。

摘　　要：目的:通过分析新医改以来2009—2018年我国31省份医院次均门诊费用、人均住院费用年均增长率的空间分布,观察各省份之间费用增长的空间相关性和差异性,为政府和各层级医疗卫生行政部门制定医疗控费政策提供政策建议。方法:描述分析我国2009—2018年各省份医院门诊、住院费用总体分布情况,利用ArcGis 10.5统计分析次均门诊、住院费用年均增长率全局空间自相关、Getis-Ord Gi*局部热点,探究各省份门诊和住院费用的空间相关性,并找出门诊住院费用的冷热点区域。结果:新医改以来我国门诊住院费用呈现持续上涨的状态,且省际之间门诊住院费用差异较大;各省份门诊住院费用全局Moran’sI大于0,在空间分布上具有正相关性,差异具有统计学意义(P<0.05);Getis-Ord Gi*热点分析显示,高值聚集区域大部分基本集中在西部地区,无冷点聚集区域。结论:新医改对我国医疗费用控制起到了一定作用,但我国各省份门诊住院费用仍持续上涨,因此需建立长效控费机制,但地区之间的差异性,需因地制宜地制定调整政策;注意东部地区费用增长稳定性的同时,重点关注西部热点地区。Objective:By analyzing the spatial distribution of average outpatient cost per time and average hospitalization cost per capita in 31 provinces of China from 2009 to 2018,the spatial correlation and differences of cost growth among different provinces were observed,so as to provide policy suggestions for the government and medical and health administrative departments at various levels to formulate medical fee control policies.Methods:It describes and analyzes the overall distribution of outpatient and inpatient expenses of hospitals in each province in China from 2009 to 2018.ArcGis 10.5 is used to analyze the global spatial autocorrelation of average outpatient and inpatient expenses growth rate and Getis-Ord Gi*local hot spots,to explore the spatial correlation of outpatient and inpatient expenses in each province,and to find out the cold hot spots of outpatient and inpatient expenses.Results:Since the new medical reform,the outpatient and inpatient expenses in China have been rising continuously,and the differences between provinces are large;the overall Moran’s I of each province is larger than 0,and there is a positive correlation in the spatial distribution,and the difference is statistically significant(P<0.05);the GETIS ord GI*hot spot analysis shows that the majority of the high value accumulation areas are mainly concentrated in the western region,and there is no cold spot accumulation area.Conclusion:The new medical reform has played a certain role in the control of medical expenses in China,but the outpatient and inpatient expenses in various provinces of China are still rising.Therefore,it is necessary to establish a long-term cost control mechanism.However,due to the differences between regions,adjustment policies should be formulated in accordance with local conditions.Attention should be paid to the stability of cost growth in the eastern region,while focusing on the western hot spots.

关 键 词：医院 次均门诊费用 人均住院费用 空间相关性 医药卫生体制改革 

分 类 号：R19[医药卫生—卫生事业管理] R197[医药卫生—公共卫生与预防医学]