重庆市公立医院资源自主配置、医疗行为偏好对医疗费用的影响分析  

The Effect of Resource Independence Allocation and Medical Behavior Preference on Medical Expenditure of Public Hospitals in Chongqing

作　　者：谭华伟 张培林 皮星[1,2] 张云 程伟 TAN Hua-wei;ZHANG Pei-lin;PI Xing(Chongqing hospital cost management research center;the Ninth Peaple’s Hospital of Chongqing,Chongqing,400700,China)

机构地区：[1]重庆市医院成本管理研究中心,重庆400700 [2]重庆市第九人民医院,重庆400700

出　　处：《中国卫生经济》2021年第11期55-59,共5页Chinese Health Economics

基　　金：重庆市社会科学规划项目(2020YBGL98、2019YBJJ033);重庆市制度创新项目(cstc2020jsyj-zzysbAX0043);四川医事卫生法治研究中心课题项目(YF20-Q14);北碚区科委制度创新项目(2020-37)。

摘　　要：目的:考察重庆市公立医院资源自主配置、医疗行为偏好程度,并探究其对医疗费用的影响机制。方法:利用固定效应面板回归检验资源自主配置、医疗行为偏好对医疗费用增长的影响机制。结果:回归结果显示,床位自主程度、人员自主程度、住院门诊收入比、门诊住院工作量比对门急诊次均费用的影响具有统计学意义;人员自主程度、住院门诊收入比、人价收入占比、平均住院日对每出院患者医疗费用的影响具有统计学意义。结论:重庆市公立医院资源自主配置程度整体呈上升趋势,而医院医疗行为偏好变化具有非对称性特征。应整合区域卫生规划和医院等级评审指导功能,优先调控公立医院人员规模及其结构,建立与功能定位相适应的调控机制。Objective:It aims to examine the effect of resource independence allocation and medical behavior preference on medical expenditure of public hospital in Chongqing.Methods:The fixed-effect panel regression model was used to examine the effect of resource independence allocation and medical behavior preference on medical expenditure.Results:Fixed-effect panel regression found that degree of bed independence,degree of staff independence,ratio of inpatient income and outpatient income,ratio of inpatient workload and outpatient workload significantly affect average cost of outpatient,and degree of staff independence,ratio of inpatient income and outpatient income,ALOS significantly affect average cost of inpatient.Conclusions:The resource independent allocation of public hospital is on the rise in Chongqing,while the change of medical behavior preference is asymmetric.It is suggested to adjust the guidance function of regional health planning and hospital level auditing,optimize the scale and structure of staffs in public hospitals,establish a regulatory mechanism compatible with functional positioning.

关 键 词：公立医院 资源自主配置 医疗行为偏好 医疗费用 重庆 

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]