药品耗材零加成下某三甲医院患者住院费用变化分析  

Analysis of changes in hospitalization expenses of patients in a GradeⅢhospital under zero mark-up of drug consumables

作　　者：赵莉 唐菁 乔乐来 李东桥 贾秀萍[1] ZHAO Li;TANG Jing;QIAO Lelai;LI Dongqiao;JIA Xiuping(School of Public Health,Dalian Medical University,Dalian,Liaoning Province,116044,PRC)

机构地区：[1]大连医科大学公共卫生学院,辽宁省大连市116044

出　　处：《中国医院》2022年第3期40-42,共3页Chinese Hospitals

摘　　要：目的:以湖南省某三级甲等综合医院为例,评价药品和耗材零加成前后患者住院次均费用及其结构变化情况和关联程度,为缓解患者就医负担及完善政策提供参考依据。方法:运用结构变动度和灰色关联分析法,分析药品耗材零加成政策对某三甲医院患者住院费用构成和次均费用变化情况的影响程度。结果:取消药品加成后,结构变动贡献率最大的是药品费用和耗材费用;取消耗材加成后,结构变动度贡献率最大的是医技费用和医疗费用。经灰色关联分析,药品耗材零加成前后对次均费用影响最大的费用由药品费用和耗材费用变为医技费用和医疗费用,其中医技费用排位第一,关联系数为1.000。结论:患者住院费用结构持续优化,药品耗材零加成政策取得明显效果。建议建立科学控费评价指标体系,进一步优化费用结构,探索药品耗材动态管控方法,促进医院良性发展,发挥医保监管引导作用,规范医生诊疗行为。Objective:Taking a GradeⅢLevel A general hospital in Hunan Province as an example,to evaluate the average hospitalization costs of patients before and after zero mark-up on drugs and consumables,their structural changes and the degree of correlation,so as to provide a reference for relieving patients’medical burden and improving policies.Methods:Using the structural change degree and grey relational analysis method,the influence degree of the zero mark-up policy on drug consumables on the composition of hospitalization expenses and the change of the average cost of patients in a GradeⅢhospital was analyzed.Results:After canceling the drug mark-up,the cost of drugs and consumables contributed the most to the structural change;after adding the consumables,the largest contribution to the structural change was the medical technology cost and the medical cost.According to the grey correlation analysis,the cost that has the greatest impact on the average cost before and after the zero mark-up of drug consumables changes from drug cost and consumable cost to medical technology cost and medical cost,among which medical technology cost ranks first with a correlation coefficient of 1.000.Conclusion:The structure of hospitalization expenses for patients has been continuously optimized,and the zero-addition policy of drug consumables has achieved obvious results.It is recommended to establish a scientific evaluation index system for cost control,further optimize the cost structure,explore the dynamic management and control methods of pharmaceutical consumables,promote the healthy development of hospitals,give play to the guiding role of medical insurance supervision,and standardize doctors’diagnosis and treatment behavior.

关 键 词：药品零加成 耗材零加成 住院费用 

分 类 号：R195[医药卫生—卫生统计学]