医耗联动改革对医院门急诊检查服务量和费用的影响分析  

Analysis of Impact of Reform of Medical Consumption Linkage on Service Volume and Cost of Outpatient and Emergency Examinations in Hospitals

作　　者：王存龙 李奕璋[1] WANG Cun-long;LI Yi-zhang(Peking University People's Hospital)

机构地区：[1]北京大学人民医院

出　　处：《医院管理论坛》2021年第12期30-33,共4页Hospital Management Forum

摘　　要：目的分析北京市医药分开和医耗联动综合改革对门急诊检查的服务量和费用的影响。方法收集2016年1月-2019年12月门急诊检查服务量和费用相关数据,采用描述性分析和基于分段回归模型的间断时间序列方法,分析两次综合改革对门急诊检查服务量和费用的影响,并探讨产生这些影响的原因。结果医药分开综合改革使每百门急诊人次中总检查、CT检查和MRI检查人次分别上升至28.21次、2.81次和1.51次,费用占比分别下降至8.64%、0.89%、1.05%,改革当月总检查、CT检查和MRI检查次均费用和费用占比均显著下降(p<0.05)。医耗联动综合改革使病理费用占比上升至2.66%,改革当月病理检查次均费用和费用占比均显著上升(p<0.05)。结论北京市医药分开和医耗联动综合改革实现了对检查费用调控的目标,使门急诊检查费用更趋于合理的同时提升检查服务的效率。Objective To analyze the impact of the comprehensive reform of the separating medical treatment and drug sales and the linkage of medical consumption in Beijing on the service volume and cost of outpatient and emergency examinations.Methods Data on the service volume and cost of outpatient and emergency examinations from January 2016 to December 2019 was collected.Descriptive analysis and the discontinuous time series method based on the segmented regression model were used to analyze the effect of the two comprehensive reforms on the service volume and cost of outpatient and emergency examinations.The reasons for these impacts were explored.Results The comprehensive reform of the separating medical treatment and drug sales increased the number of total examinations,CT examinations,and MRI examinations per 100 emergency department visits to 28.21,2.81,and 1.51,respectively,and the proportion of expenses dropped to 8.64%,0.89%,and 1.05%,respectively.In the month of reform,the average cost and the proportion of cost for total examination,CT examination and MRI examinations decreased significantly(p<0.05).The comprehensive reform of medical consumption linkage increased the proportion of pathological expenses to 2.66%,and the average cost of pathological examinations and the proportion of expenses in the month of the reform increased significantly(p<0.05).Conclusion The comprehensive reform of separating medical treatment and drug sales and the linkage of medical consumption in Beijing has achieved the goal of regulating and controlling examination costs,making outpatient and emergency examination costs more reasonable while improving the efficiency of examination services.

关 键 词：医药分开综合改革 医耗联动综合改革 间断时间序列 

分 类 号：R197.3[医药卫生—卫生事业管理]