河北省公立医院医药价格改革对医疗费用的影响研究--以河北省某公立医院为例  

Study on the influence of medical price reform on medical expenses in public hospitals in Hebei province:a public hospital as an example

作　　者：徐泽华[1] 石建阳 魏浩然 张红杰[1] XU Zehua;SHI Jianyang;WEI Haoran;ZHAGN Hongjie(College of Public Health Sciences,Hebei University,Baoding 071000,China;College of Public Health,Jilin University,Changchun 130012,China)

机构地区：[1]河北大学公共卫生学院,河北保定071000 [2]吉林大学公共卫生学院,吉林长春130012

出　　处：《医学研究与教育》2023年第1期52-58,共7页Medical Research and Education

基　　金：河北省医学科学研究课题计划项目(20190124)。

摘　　要：目的对比河北省某公立医院医药价格改革(简称医改)前后患者门诊和住院费用,分析医改前后患者医疗费用及其结构的变化,对医改效果进行评价。方法从河北省某公立医院医疗信息系统中调取医改前和医改后患者的费用资料,对医疗费用、费用结构进行对比和分析。结果医改后门诊次均费用增加17.73元,增幅为5.34%,主要增加治疗费和化验费。住院患者次均医疗费用减少378.71元,降幅为2.28%,药费降幅最大13.76%(次均费用降低931.14元),其次是卫生材料费12.15%(次均费用降低449.06元);同时护理费(109.89%)、诊查费(21.63%)、手术费(18.66%)和治疗费(17.87%)都有不同程度升高。住院患者单病种分析中,脑梗死患者次均费用减少1664.45元,冠状动脉性心脏病减少2774.05元,慢性阻塞性肺病增加315.88元。结论医改后患者费用降低,减少药费构成比,提升护理费、诊查费、治疗费、手术费等体现医务人员技术价值费用构成比,对费用结构起到优化作用。Objective To analyze the changes of the medical expenses and cost structure of medical insurance before and after public hospital medical price reform in Hebei province,and evaluate the effect of the medical price reform.Methods All the data before and after the medical price reform were collected from the information system in the public hospital,the data were analyzed on the medical expenses and cost structure of medical insurance.Results After the medical reform,the average cost per time of outpatient increased slightly by the proportion of 5.34%(17.73 yuan)because of the cost increase of treatment and laboratory primarily.However,the average cost per time of inpatient decreased significantly by the proportion of 2.28%(378.71 yuan),with the decrease of medicine fees(13.76%,931.14 yuan)and cost of sanitary materials(12.15%,449.06 yua).On the other hand,the cost of nursing(109.89%),consultation(21.63%),surgery(18.66%)and treatment(17.87%)had increased significantly.In terms of single disease,the average cost per time of both cerebral infarction and coronary heart disease decreased with the cost of 1664.45 yuan and 2774.05 yuan separately,however the average cost per time of chronic obstructive pulmonary disease increased(315.88 yuan).Conclusion After the reform in public hospitals,the cancellation of the drug markup policy was fully implemented,which reduced the total proportion of drug costs,and increase the proportion of nursing,consultation,surgery and treatment,the cost medical structure were optimized.

关 键 词：医药价格改革 公立医院 医疗费用 费用结构 

分 类 号：R19[医药卫生—卫生事业管理]