北京市医药分开和医耗联动综合改革背景下中医类医院治疗费用研究  

Impacts of the Comprehensive Reform of Medicial-Pharmaceutical Separation and Comprehensive Re⁃form of Medical Comsmption Linkage on the Treatment Costs of Traditional Chinese Medicine Hospitals in Beijing

作　　者：蒋艳[1] 曹桑蔚 周奕汝 程薇[2] Jiang Yan;Cao Sangwei;Zhou Yiru(School of Management of Beijing University of Chinese Medicine,Beijing,102488,China;不详)

机构地区：[1]北京中医药大学管理学院,北京102488 [2]北京中医药大学国家中医药发展与战略研究院,北京100029

出　　处：《中国医院管理》2023年第10期22-25,共4页Chinese Hospital Management

基　　金：北京市卫生健康委员会“2020年基于SHA2011的北京市经常性卫生费用核算”项目(BUCM-2021-KJ-GL007)。

摘　　要：目的研究北京市医药分开和医耗联动综合改革前后中医类医院治疗费用的变化情况。方法通过多阶段分层整群抽样,运用《卫生费用核算体系2011》,核算北京市中医类医院的治疗费用情况。结果2016—2019年,北京市中医类医院治疗费用由229.83亿元增长到309.86亿元,年均增速为7.61%,二、三级中医类医院治疗费用年均增速分别为10.26%、3.56%,二级中医类医院费用占比从58.96%增长到63.42%,二级医院门急诊、住院服务量增长均快于三级医院。二、三级医院门急诊、住院药占比均下降8个百分点以上,但门急诊中药饮片费用占比分别增长2.45、4.43个百分点,住院耗占比分别增长2.94、2.14个百分点。结论医药分开和医耗联动综合改革的实施一定程度上优化了中医类医院治疗费用的流向和结构,提升了中医类服务的技术劳务价值,但改革可能导致诊疗行为变化。应注意政策的协调性,关注改革的长期效果。Objective To analyze the impact of the comprehensive reforms of medicial-pharmaceutical separation and medicial consumption linkage on the treatment costs of Traditional Chinese Medicine(TCM)hospitals in Beijing.Methods Based on a multi-stage stratified cluster sampling method,a System of Health Accounts 2011 was used to calculate the treatment costs of TCM hospitals.Results From 2016 to 2019,the treatment costs of TCM hospitals in Beijing increased from 22.98 billion yuan to 30.98 billion yuan,with an average annual growth rate of 7.61%;the an⁃nual growth rate of secondary and tertiary TCM hospitals was 10.26%and 3.56%respectively;the proportion of treatment cost in secondary TCM hospitals increased from 58.96%to 63.42%.The growth of outpatient and emer⁃gency and inpatient services in secondary TCM hospitals was faster than that in tertiary TCM hospitals.The propor⁃tion of outpatient and emergency medicines and inpatient medicines in secondary and tertiary TCM hospitals de⁃creased by more than 8 percentage points,but the proportion of outpatient and emergency Chinese herbal medicines expenses increased by 2.45 and 4.43 percentage points respectively,and the proportion of inpatient consumption increased by 2.94 and 2.14 percentage points respectively.Conclusion The implementation of the comprehensive re⁃forms of medicial-pharmaceutical separation and medicial consumption linkage in Beijing has optimized the flow and structure of medical expenses in TCM hospitals and improved the value of TCM technical service.However,the re⁃forms may lead to some changes of the behavior of diagnosis and treatment in TCM hospitals.Therefore,we should pay attention to the coordination of policies and long-term effects of reforms at large.

关 键 词：治疗费用 中医类医院 医药分开综合改革 医耗联动综合改革 

分 类 号：R197.322[医药卫生—卫生事业管理]