新医改对四川省某公立医院医疗费用结构的影响  

The Impact of the New Medical Reform on the Medical Expense Structure of a Public Hospital in Sichuan Province

作　　者：陆婷婷[1] 谭坤 Lu Tingting;Tan Kun(Suining Central Hospital,Suining,Sichuan Province,629000,China;不详)

机构地区：[1]遂宁市中心医院,四川省遂宁市629000 [2]四川省卫生健康信息中心,四川省成都市610015

出　　处：《中国病案》2023年第11期41-44,共4页Chinese Medical Record

基　　金：四川省遂宁市市级科技计划项目基金-四川省遂宁市区域性医疗联合体运行效果的实证研究(2014s31)。

摘　　要：目的分析新医改以来四川省某公立医院医疗费用结构变化,为进一步优化费用结构、深化改革提供参考。方法选取四川某地级市三级甲等综合公立医院作为研究对象,采用描述性分析对2017年1月1日-2020年12月31日医疗费用相关指标变化情况进行分析,利用结构变动度分析门诊次均费用、住院次均费用各项明细费用的变动情况。结果药品费用构成比的变动对次均门诊费用的结构变动贡献率最高,达到44.88%,治疗费次之为23.86%,两者累计贡献率达68.74%,是次均门诊费用结构变动的主要项目;同期引起次均住院费用变动的前3项因素依次为药品费、手术费、检查检验费用,结构变动贡献率分别为31.01%、21.32%、16.10%,3者累计贡献率达68.43%。结论在新医改政策的引导下,某院医疗费用结构逐步调整,需对检查检验、卫生材料变化情况保持关注;进一步争取当地相关部门支持,配合政策持续优化费用结构。Objectives This study aims to analyze the changes in the medical expense structure of a large municipal public hospital in Sichuan Province since the new medical reform and provide suggestions for further optimizing the expense structure and deepening the reform.Methods A tertiary comprehensive public hospital in a prefecture-level city in Sichuan was selected as the research object.The descriptive analysis method was used to analyze the changes in indicators related to the hospital's medical expenses from January 1,2017 to December 31,2020.The structural changes analysis method was used to analyze the changes in the detailed expenses of the average outpatient fee and the average hospitalization fee.Results The change in the composition ratio of drug expenses had the highest contribution rate to the structural change of the average outpatient expense per visit,reaching 44.88%,followed by treatment expenses at 23.86%,and the cumulative contribution rate of the two was 68.74%,which were the main item for the change in the structure of the average outpatient fee per visit.During the same period,the top three factors causing changes in the average hospitalization expenses were drug expenses,surgical expenses,and inspection and testing expenses.The contribution rates of structural changes were 31.01%,21.32%,and 16.10%,respectively,and the cumulative contribution rate of the three reached 68.43%.Conclusions Under the guidance of the new medical reform policy,the cost structure of the hospital has been gradually adjusted. It is necessary to pay attention to inspections and changes in sanitary materials, seek supportfrom relevant local departments, and continue to optimize the cost structure in line with policies.

关 键 词：新医改 地市级公立医院 医疗费用 结构变动度 

分 类 号：R197.322[医药卫生—卫生事业管理]