药品零差率政策对中国西部市级公立医院住院费用的影响分析  

Analysis of the Influence of The Drug Zero Mark-up Policy on the Hospitalization Expenses of Municipal Public Hospitals in Western China

作　　者：邴龙飞 余兰 孙玉凤 王家奎 Bing Longfei(School of Public Health and Management,Ningxia Medical University,Yinchuan,P.R.China)

机构地区：[1]宁夏医科大学公共卫生与管理学院,宁夏银川750004 [2]宁夏环境因素与慢性病控制重点实验室 [3]青铜峡市医保中心

出　　处：《中国卫生事业管理》2022年第10期769-773,共5页Chinese Health Service Management

基　　金：宁夏自治区卫生健康系统科研课题“银川药品零差率政策对患者就医负担的影响研究”宁卫办发[2020]256号;国家自然科学基金地区基金项目“中国西部政府医疗卫生支出受益归属的测算研究”(71764021)。

摘　　要：目的:分析药品零差率政策对中国西部不同类型的市级公立医院住院费用结构影响,探讨影响住院费用结构变化的因素。方法:采用新灰色关联法和结构变动度,分析2014~2020年西部6家市级公立医院(包括综合性医院、专科医院、中医医院)的住院费用。结果:2014~2020年间,住院费用中结构变动贡献率最大的费用,6家医院总体(28.81%)、综合医院(32.80%)和专科医院(32.04%)均为西药费且均呈负向变动,而中医医院为中成药费(41.81%)呈负向变动;灰色关联结果显示,在6家医院总体、综合医院里西药费的关联性最大,中医医院、专科医院中治疗费的关联性最大。结论:西部市级公立医院住院收入结构得到优化,不同类型医院住院费用结构的变动以及影响因素存在差异性,政府需针对不同类型医院完善配套政策,综合施策促进各类公立医院均衡发展。Objective To analyze the influence of drug zero markup policy on the inpatient expenditure structure of municipal public hospitals with different types in western China,and explore the factors to affect the changes of inpatient expenditure structure.Methods Using the new grey correlation method and degree of structural variation,the hospitalization expenses of 6 municipal public hospitals(including general hospitals,specialist hospitals,and Chinese medicine hospitals)in western China from 2014 to 2020 were analyzed.Results From 2014 to 2020,for the hospitalization expenses,the expenses that contributed the most to the structural changes were all western medicine expenses and had negative changes in 6 hospitals,which was 28.81%totally,32.80%in general hospitals and 32.04%in specialized hospitals,respectively.While the most contribution of the structure change was in Chinese patent medicine expenses(41.81%)in traditional Chinese medicine hospitals and had negative change.The grey correlation results showed that the six hospitals had the most relevance in total and general hospitals for western medicine fees,while traditional Chinese medicine hospitals and specialized hospitals had the most relevance for treatment fees.Conclusion The inpatient income structure of municipal public hospitals in western China has been optimized.And the changes in inpatient expense structure of hospitals with different types and their influencing factors were different.The government needs to improve supporting policies for different hospitals,and integrate multiple policies to promote the balanced development of various public hospitals.

关 键 词：药品零差率 新灰色关联 结构变动度 住院费用 

分 类 号：R197[医药卫生—卫生事业管理]