2015-2019年重庆市公立医院医疗成本核算结果与分析  

Medical cost accounting results and analysis of public hospitals in Chongqing from 2015 to 2019

作　　者：张云 张培林 谭华伟 刘宪 皮星 彭琳 程伟 郑万会 方雄鹰 陈菲[2] ZHANG Yun;ZHANG Peilin;TAN Huawei;LIU Xian;PI Xing;PENG Lin;CHENG Wei;ZHENG Wanhui;FANG Xiongying;CHEN Fei(Chongqing Hospital Cost Management Research Center,No.69,Jialing Village,Beibei District,Chongqing,400700,PRC)

机构地区：[1]重庆市医院成本管理研究中心,重庆北碚400700 [2]重庆医科大学公共卫生与管理学院,重庆渝中区400016

出　　处：《中国医院》2021年第10期35-38,共4页Chinese Hospitals

基　　金：重庆市社会科学规划项目(2020YBGL98);四川医事卫生法治研究中心课题(YF20-Q14);北碚区科委制度创新项目(2020-37)。

摘　　要：目的:了解重庆市公立医院医疗成本规模及变化趋势,为公立医院高质量发展提供决策参考。方法:利用2015-2019年重庆市21所公立医院成本核算数据,运用描述性方法探讨公立医院医疗成本的变化趋势,采用独立样本t检验比较不同类别公立医院医疗成本差异。结果:重庆市平均每所公立医院医疗成本从2015年的77345万元增长到2019年的119045万元,年均增速为11.38%。临床门诊类、临床住院类、医疗技术类、医疗辅助类、行政后勤类科室医疗成本平均占比分别为31.58%、46.79%、18.82%、10.88%和1.93%。二级医院、区县医院平均医疗成本分别小于三级医院、市属医院,差异均具有统计学意义(t=-4.486,P=0.000;t=4.724,P=0.000)。结论:重庆市公立医院医疗成本呈波动增长趋势,增速高于医疗收入和地区GDP;公立医院医疗成本规模及增长在科室类别和机构类别上出现分化。建议重庆市公立医院明确医院内部成本管控的优先目标,实现成本领先战略,提高成本信息集成与透明化程度。Objective:To understand the scale and changing trend of medical cost in public hospitals in Chongqing,and to provide reference for decision-making of high quality development of public hospitals.Methods:Based on the cost accounting data of 21 public hospitals in Chongqing from 2015 to 2019,descriptive methods were used to discuss the changing trend of medical costs in public hospitals,and independent sample t test was used to compare the differences of medical costs in different types of public hospitals.Results:The average medical cost per public hospital in Chongqing increased from 773.45 million yuan in 2015 to 1190.45 million yuan in 2019,with an average annual growth rate of 11.38%.The average medical costs of clinical outpatient department,clinical inpatient department,medical technology department,medical auxiliary department and administrative and logistics department were 31.58%,46.79%,18.82%,10.88% and 1.93%,respectively.The average medical cost of each level-II hospital and district and county hospital was lower than that of level-Ⅲ hospital and municipal hospital,respectively,and the differences were statistically significant (t=-4.486,P=0.000;t=4.724,P=0.000).Conclusion:The medical cost of public hospitals in Chongqing fluctuates,and its growth rate is higher than that of medical income and regional GDP.The scale and growth of medical cost in public hospitals are differentiated in the categories of departments and institutions.It is suggested that Chongqing public hospitals should clarify the priority objectives of internal cost control,realize the cost leadership strategy,and improve the integration and transparency of cost information.

关 键 词：公立医院 医疗成本 医院科室 成本核算 变化趋势 

分 类 号：R195[医药卫生—卫生统计学]