基于项目分类的不同等级医院医疗服务项目成本补偿比较研究  

Comparative Study on Cost Compensation of Medical Service Projects in Hospitals of Different Grades based on Project Classification

作　　者：焦培峻 皮星 张云 何孝崇 谭华伟 JIAO Peijun;PI Xing;ZHANG Yun;HE Xiaochong;TAN Huawei(Chongqing Hospital of Traditional Chinese Medicine,Chongqing 400011,China;不详)

机构地区：[1]重庆市中医院,重庆400011 [2]重庆市医院成本管理研究中心,重庆430070 [3]陆军军医大学,重庆400038 [4]华中科技大学同济医学院医药卫生管理学院,湖北武汉430030

出　　处：《卫生经济研究》2025年第2期51-54,共4页

基　　金：重庆市社会科学规划项目“健康老龄化战略下慢性病老人的社区整合护理保障体系研究”(2023NDYB105)。

摘　　要：目的:比较市级统筹区域不同等级医院、不同类别医疗服务项目成本及其补偿率。方法:采用作业成本法,核算G市18家公立医疗机构常见的通用型和复杂型医疗服务项目成本。结果:市级、县级、乡级医疗机构的通用型医疗服务项目整体补偿率分别为13.34%、17.03%、58.37%,复杂型医疗服务项目整体补偿率分别为55.56%、78.08%、46.16%;市级、县级医院的通用型项目成本补偿显著低于乡镇卫生院,县级医院的复杂型项目成本补偿显著高于市级医院和乡镇卫生院。结论:医疗服务项目成本补偿率整体偏低,通用型医疗服务项目成本补偿率显著低于复杂型,不同等级医院之间存在价格交叉补贴效应;需以成本和价值为导向,厘清医疗服务价格动态调整的优先序和协同性。Objective To compare the costs and compensation rates of medical service projects in hospitals of different grades and categories within a municipal-level coordinated region.Methods Using the operation cost method,the costs of common and complex medical service projects in 18 public medical institutions in City G were calculated.Results The overall compensation rates for common medical service projects were 13.34%,17.03%,and 58.37%in municipal,county,and township-level hospitals,respectively,and the overall compensation rates for complex medical service project were 55.56%,78.08%,and 46.16%,respectively.Municipal and county hospitals showed significantly lower compensation rates for common projects compared to township-level hospitals,while county hospitals showed significantly higher compensation rates for complex projects compared to municipal and township-level hospitals.Conclusion The overall cost compensation rates for both common and complex projects are relatively low,with compensation rates for common medical service projects significantly lower than those for complex projects,and there is a cross-subsidization effect of prices among hospitals of different grades.It is necessary to clarify the priorities and synergies of the dynamic adjustment of the prices of medical services guided by costs and values.

关 键 词：医疗服务项目 成本核算 成本补偿 医疗机构 

分 类 号：R19[医药卫生—卫生事业管理]