2015-2021年我国县级中医院补偿机制现状分析  

Analysis of the Current Compensation Mechanism in County-level Traditional Chinese Medicine Hospitals in China from 2015 to 2021

作　　者：邓伟峰 舒奎 李梦蝶 邓文欣 翁开源 DENG Weifeng(School of Medicine and Business,Guangdong Pharmaceutical University,Guangzhou,Guangdong,510006,China)

机构地区：[1]广东药科大学医药商学院,广东广州510006 [2]南方医科大学生物医学工程学院,广东广州510515 [3]国家药品监督管理局药物警戒技术重点实验室,广东广州510006

出　　处：《医学与社会》2024年第7期130-137,共8页Medicine and Society

基　　金：2022年广东省教育厅普通高校重点科研项目专项资金《卫生经济学与社会保障研究创新团队》重点项目,编号为2022WCXTD011;2021年广东省哲学社会科学规划项目《“建设粤港澳大湾区”和“支持深圳建设中国特色社会主义先行示范区”背景下建设健康深圳研究》,编号为GD21SQGL01。

摘　　要：目的:分析2015-2021年我国县级中医院补偿机制现状,为县级医院的发展提供参考依据。方法:运用结构变动度方法、灰色关联度分析方法对2015-2021年我国县级中医院收入结构变化情况进行研究,并分析收支盈余状况、药品收入、财政收入等信息,探索县级中医院补偿机制特点。结果:2015-2021年县级中医院院均财政补助金额增长了2.42倍,占总收入比重整体呈现上升趋势。其中基本支出增涨最为明显,变化范围在51.04%-63.30%;医疗结余率由7.87%负增长至-0.80%,不含财政补偿时医院亏损程度总体上不断加剧。盈余金额中关联度排前3位的是财政补助收入、其他费用支出、人员经费支出;医疗服务收入的总体结构变动值为4.67%,挂号、手术、护理收入呈现负向变动,而治疗收入结构贡献率最大,达到了78.37%。药占比由35.40%下降至25.34%,其中西药和中成药逐年减少,而中药饮片比重不断增加,西药占据药品收入的6成,中药饮片和中成药不到2成。结论:财政补助下我国县级中医院运营良好,仍需特别关注发展不均衡的问题。县级中医院肩负责任增多,基本支出不断增长,同时自身的盈利能力相对较低,需要依靠财政补助保障医院运营与发展。收入结构趋于合理,但医疗服务价格有待进一步提高。Objective:To analyze the compensation status of county-level traditional Chinese medicine hospitals in China from 2015 to 2021,reveal the problems and deficiencies in the income compensation process of county-level traditional Chinese medicine hospitals under the medical reform policy,and propose optimization strategies for hospital development.Methods:Using the method of degree of structural change,this study investigated the changes in the income structure of county-level traditional Chinese medicine hospitals in China from 2015 to 2021,and analyzed information such as income and expenditure surplus,drug revenue,and fiscal revenue to explore the characteristics of compensation methods for county-level traditional Chinese medicine hospitals.Results:From 2015 to 2021,the average financial subsidies for county-level traditional Chinese medicine hospitals increased by 2.42 times,with a growing proportion in total revenue.Notably,basic expenditures surged between 51.04%and 63.30%.The medical surplus ratio declined from 7.87%to-0.80%,indicating an overall increase in hospital losses without considering fiscal compensations.The top three factors correlated with surplus were financial subsidies,other expenses,and personnel expenditures.Overall,the medical service income structure changed by 4.67%,with negative shifts in registration,surgery,and nursing income,while treatment income contributed the most at 78.37%.Drug percentage decreased from 35.40%to 25.34%,primarily due to decreasing Western and conventional Chinese medicine,contrasting the continuous rise of traditional Chinese medicine decoctions.Western medicine constituted 60.00%of drug revenue,while traditional Chinese medicine decoctions and conventional Chinese medicine comprised less than 20.00%combined.Conclusion:With fiscal subsidies,county-level traditional Chinese medicine hospitals in China operate well,but special attention is still needed to address the issue of uneven development.These hospitals are taking on increased responsibilities,with basic expe

关 键 词：中医药管理 补偿机制 中医院 县级 财政补助 

分 类 号：R-05[医药卫生]