新医改后公立精神专科医院经济运行现状及问题分析--以山东省为例  

Economic Operation Status and Problem Discussion of Public Psychiatric Hospitals after the New Medical Reform:Take Shandong as an Example

作　　者：王灿[1] 胡丽丽[1] 王延祜[1] 高军[1] WANG Can;HU Lili;WANG Yanhu;GAO Jun(Shandong Mental Health Center,Jinan,250014,China)

机构地区：[1]山东省精神卫生中心公共卫生部,山东济南250014

出　　处：《中国社会医学杂志》2022年第6期716-719,共4页Chinese Journal of Social Medicine

基　　金：山东省医药卫生科技发展计划项目(2017WS620)。

摘　　要：目的分析新医改后公立精神专科医院的经济运行现状及存在的问题,为进一步深化医改提供参考依据。方法在山东省内,对随机抽取的一家省级公立精神专科医院及按照社会经济发展水平随机抽取的5个市的所有市级、县级公立精神专科医院,开展经济运行情况调查,收集2015-2018年经济运行数据,进行描述性统计分析,并与全国公立医院和综合医院的经济运行平均水平进行比较。结果新医改后,山东省公立精神专科医院收支增长较快,但支出增长率逐年下降;医疗收支占总收支的比例为85.56%,较全国公立医院和综合医院低;财政投入占比逐年下降,总药占比下降了6.48%,技术劳务性收入占比升高,但在门诊和住院中差别很大(门诊占6.84%,住院占63.98%)。结论新医改后,山东省公立精神专科医院运行好转,收支结构有所改善;建议政府加大财政投入,医院要完善自主监管机制,强化门诊控费管理,进一步改善收入结构。Objective To analyze and discuss the current economic operation and existing problems of public psychiatric hospitals after the new medical reform,so as to provide a reference for further deepening the medical reform.Methods A randomly selected provincial,all municipal and county-level public psychiatric hospitals from 5 cities randomly sampled with different socioeconomic levels were investigated.Their economic operation data from 2015 to 2018 were collected and analyzed descriptively.Public psychiatric hospitals were compared with the average level of economic operation of public hospitals and general hospitals across the country.Results The revenue and expenditure of public psychiatric hospitals had increased rapidly after the new medical reform.But the growth rate of expenditure was declining year by year.Compared with national public hospitals and general hospitals,proportion of medical income or expenses in total revenue or expenses was lower.The proportion of fiscal investment were decreased year by year.The proportion of medicine had decreased 6.48%.The proportion of technical labor income was increased with a great difference between outpatient and hospital income(6.84%vs 63.98%).Psychiatric hospitals were running well after the new medical reform.Conclusion After the new medical reform,the operation of public psychiatric hospitals had improved.Revenue and expenditure structures are significantly improved.The government should increase financial investment.Psychiatric hospitals should complete self-regulatory mechanism and cost-controlling of outpatient to improve income structure.

关 键 词：新医改 精神专科医院 公立医院 经济运行 

分 类 号：R197.5[医药卫生—卫生事业管理]