药品零加成政策对慢性心力衰竭患者次均住院费用变化影响结构分析  

Changes and analysis on the structure of CHF average hospitalization cost under the implementation of drug zero addition policy

作　　者：吴燕婷 李萍 吴寒 WU Yan-ting;LI Ping;WU Han(School of Medicine,Tongji University,Pudong Neu District,Shanghai 200092,China;不详)

机构地区：[1]同济大学医学院,上海浦东新区200092 [2]浦东新区光明中医医院院长办公室

出　　处：《现代预防医学》2021年第23期4304-4306,4344,共4页Modern Preventive Medicine

基　　金：浦东新区卫健委卫生科技项目联合攻关(PW2020D-3)。

摘　　要：目的分析药品零加成政策对于慢性心衰住院费用的影响和结构变动趋势,为推进医改的实施和加强医院内部管理提供依据。方法收集上海某医院2016—2019年慢性心衰患者住院费用,采用结构变动度法和灰色关联度法分析各项费用的结构变动情况及其与总费用的关联程度。结果 2016—2019年住院费用总结构变动度为24.49%;药费及耗材费呈下降趋势,诊断费及综合服务费上升;药费结构变动贡献率最大(34.75%),其次是诊断费(31.24%),两项累积贡献率达65.99%;与次均住院费用关联度从高到低前三项为诊断费(0.86)、药费(0.79)和耗材费(0.72)。结论样本医院药品零加成政策的实施取得显著的成效。今后医院应建立合理评估机制,进一步控制药费及耗材费,加强诊断费的监督管理,优化医疗费用结构。Objective To analyze the impact of drug zero-plus policy on the hospitalization cost and the structural change trend, and to provide a basis for promoting the implementation of the medical reform and strengthening the hospital internal management. Methods The hospitalization expenses of chronic heart failure from 2016 to 2019 in one hospital of Shanghai were collected. And the structural changes of each cost and the correlation degree were analyzed by the structural variation method and grey correlation degree method. Results From 2016 to 2019, the total structural variation of hospitalization expenses was 24.49%. The cost of drugs and consumables decreased, while diagnosis and comprehensive service fees increased. Drug payment structural changes had the largest contribution(34.75%), followed by diagnostic cost(31.24%), and their cumulative contribution rates reached 65.99%. The first three items associated with average hospitalization costs from high to low were diagnosis costs(0.86), drug costs(0.79) and consumable costs(0.72). Conclusion The implementation of the zero-mark-up policy achieved remarkable results. In the future, hospitals should establish a reasonable evaluation mechanism to further control drug costs and consumables expenses, strengthen the supervision and management of diagnosis expenses, and optimize the structure of medical expenses.

关 键 词：药品零加成 慢性心衰 住院费用 结构分析 

分 类 号：R197.1[医药卫生—卫生事业管理]