取消耗材加成政策对县级公立医院医疗费用结构的影响  

Impacts of Zero Mark-up for Medical Consumables Policy on the Structure of Healthcare Expenditure in County Hospitals

作　　者：刘梦灵 贾明远 林倩 夏怡 史卢少博 王冬[1] LIU Meng-ling;JIA Ming-yuan;LIN Qian(School of Health Management,Southern Medical University,Guangzhou,510515,China;不详)

机构地区：[1]南方医科大学,广州510515 [2]华南师范大学,广州510006 [3]南方医科大学南方医院,广州510515

出　　处：《中国卫生经济》2021年第7期29-32,共4页Chinese Health Economics

基　　金：广东省教育厅2015年重点平台及科研项目(2015WSYS0010);广州市社会科学规划领导小组办公室关于设立2018—2020年广州市人文社会科学重点研究基地项目。

摘　　要：目的:评估广东省耗材零加成政策对县级公立医院收入结构和医疗费用结构的影响,为政策动态调整提供决策参考。方法:以广东省不同地区的6所县级公立医院为样本,采用中断时间序列方法分析政策实施前后医疗收入及患者医疗费用结构的水平变化和趋势变化。结果:药品收入占比和医疗服务收入占比在短期内分别显著增长1.32%、1.00%;门急诊费用中检查化验费用占比呈现即时下降(P<0.05),住院费用中卫生耗材费用占比在短期效益和长期影响方面均呈现显著的下降;但医疗服务费用占比增长均无统计学意义(P>0.05)。结论:广东省样本县级公立医院耗材零加成政策效果初显,医疗收入结构和医疗费用结构有所优化,但医疗服务补偿远期影响尚不明显,仍需长期跟踪评价政策效果,动态调整改革策略。Objective:To evaluate the effect of the Zero Mark-up for Medical Consumables policy on the structure of healthcare expenditure.Methods:The interrupted time series analysis was adopted to analyze the impacts on the level change and trend change of the hospital’s revenue structure and healthcare expense structure in county public hospitals of Guangdong.Results:After the implementation of Zero Mark-up for Medical consumables policy,the proportion of drug revenue and medical service revenue in total service revenue increased by 1.32% and 1.00% respectively in the short term(P<0.05).The proportion of examination and laboratory test expense per capita in outpatient decreased immediately and significantly,when the proportion of medical consumables expense per capita in inpatients showed a significant decline in both short-term and long-term effects.However,the increase in the proportion of medical service expense per capita was not statistically significant.Conclusion:The Zero Mark-up for Medical Consumable policy had optimized the structure of county public hospitals’ revenue and healthcare expenditure and the labor value of medical personnel had been improved gradually.However,the long-term effects of the policy was not yet obvious.It was necessary to evaluate the policy effects in long term and adjust the reform strategies dynamically.

关 键 词：县级公立医院 取消耗材加成 费用结构 中断时间序列 

分 类 号：R1-9[医药卫生—公共卫生与预防医学] F207[经济管理—国民经济]