珠海市药品耗材零差率政策对公立医院医疗费用影响的实证分析  

Empirical Analysis ofthe Impact of Zero-margin Price Adjustment Policy of Medical Drugs and Consumables in Zhuhai on Medical Expenses in Public Hospitals

作　　者：马玉全 张萍 陈耀平 刘军卫 沈向东 李湘君 张瑞珊 梅文华 MA Yuquan;ZHANG Ping;CHEN Yaoping;LIU Junwei;SHEN Xiangdong;LI Xiangjun;ZHANG Ruishan;MEI Wenhua(Zhuhai Integrated Traditional Chinese and Western Medicine Hospital,Zhuhai,519000,China;不详)

机构地区：[1]珠海市中西医结合医院,广东珠海519000 [2]珠海市公立医院管理中心,广东珠海519000 [3]珠海市卫生健康局/珠海市卫生和计划生育局,广东珠海519000

出　　处：《中国社会医学杂志》2023年第1期85-88,共4页Chinese Journal of Social Medicine

基　　金：珠海市医学科研基金项目(20181117A010063)。

摘　　要：目的 分析珠海市实施药品耗材零差率价格调整对全市公立医院运行状况产生的影响。方法 利用监测数据,采用比率分析法和描述性统计等,对珠海市16家公立医院零差率价格调整前后的业务量指标、费用指标、药耗占比、收入结构变化等进行对比和趋势分析。结果 政策实施后,三级医院和二级医院医疗收入年均增长率均大于改革前(改革前后年均增长率分别为12.24%、15.81%),且改革后三级医院增幅高于二级医院(分别为16.18%、13.29%),差异具有统计学意义(P<0.05)。公立医院技术服务性收入占比显著提高(三级、二级医院分别增加6.3%和5.3%)、总体药耗占比显著下降(三级、二级医院分别下降9.3%和9.2%)。结论 珠海市药品耗材零差率价格调整总体上改革效果显著,医院收入结构明显改善。但需进一步协同各项医改政策,促进医药卫生体制改革进入深水区。Objective To analyze the impact of zero-margin price adjustment of drug and consumables on the operation of public hospitals in Zhuhai.Methods Using the monitoring data, the ratio analysis and descriptive statistics were used to compare and analyze the business volume indicator, cost indicator, drug and consumables ratio and the change of income structure of 16 public hospitals in Zhuhai before and after zero-margin price adjustment.Results After the implementation of the policy, the average annual growth rate of medical income of tertiary hospitals and secondary hospitals was higher than that before the reform(12.24% and 15.81% respectively),and the growth rate of tertiary hospitals was higher than that of secondary hospitals(16.18% and 13.29% respectively),with statistical significance(P<0.05).The proportion of technical service income in public hospitals increased significantly(6.3 and 5.3 percentage points increased in tertiary and secondary hospitals, respectively),and the proportion of overall drug consumption decreased significantly(9.3 and 9.2 percentage points decreased in tertiary and secondary hospitals, respectively).Conclusion In general, the reform effect of zero-margin price adjustment of drug and consumables is remarkable in Zhuhai, and the hospital income structure is improved obviously.However, it is necessary to further coordinate with various medical reform policies to promote the reform of the medical and health system into the deep-water zone.

关 键 词：药品耗材 零差率 价格调整 公立医院 改革 

分 类 号：R979.9[医药卫生—药品] R194[医药卫生—药学]