北京市“医药分开”“医耗联动”综合改革前后肿瘤患者治疗费用分析  

Analysis on the Curative Care Expenditure of Cancer Patients before and after the Comprehensive Reform of“Medical-Pharmaceutical Separation”and“Linkage of Medical Consumption”in Beijing

作　　者：王悦 吴明 满晓玮[1] 赵丽颖[1] 蒋艳[1] Wang Yue;Wu Ming;Man Xiaowei(Beijing University of Chinese Medicine,Beijing,100029,China;不详)

机构地区：[1]北京中医药大学,北京100029

出　　处：《中国卫生经济》2025年第1期72-78,共7页Chinese Health Economics

基　　金：北京市卫生健康委“2023年基于SHA2011的北京市经常性卫生费用核算”(BUCM-2024-KJ-GL-009)。

摘　　要：目的:探究北京市“医药分开”“医耗联动”综合改革前后本地与外来就医肿瘤患者门诊、住院治疗费用的变化情况。方法:采用多阶段分层、整群抽样,依据卫生费用核算体系2011,分析2016—2019年北京市肿瘤患者治疗费用。结果:2019年肿瘤患者治疗费用情况与2016年相比,本地患者在二、三级医院治疗费用的药占比分别下降了8.62、9.26个百分点,外来就医患者在二、三级医院治疗费用的药占比分别下降了5.60、5.66个百分点,本地和外来就医患者在三级医院的耗占比下降了6.89、8.86个百分点;本地患者二级医院门诊服务量占比由30.32%增长至35.09%,住院服务量占比由43.25%增长至52.27%,外来就医患者三级医院住院服务量占比在“医耗联动”综合改革后增至91.91%。结论:综合改革对规范药品、耗材的应用成效显著且优化了不同来源肿瘤患者的就诊流向,需加强基层医疗卫生机构在肿瘤防治中的作用并重点关注外来就医患者就医负担。Objective:To explore the changes of the Curative Care Expenditure(CCE)of outpatient and inpatient among local cancer patients and foreign cancer patients before and after the comprehensive reform of medical-pharmaceutical Separation and linkage of medical consumption in Beijing.Methods:According to A System of Health Accounts 2011(SHA 2011),multi-stage stratified sampling and multi-stage stratified sampling were used to analyze the CCE of cancer patients in Beijing from 2016 to 2019.Results:Compared with 2016,the proportion of drugs in the CCE of local residents in secondary hospitals and tertiary hospitals in 2019 decreased by 8.62 and 9.26 percentage points,respectively,and the proportion of drugs in the CCE of foreign patients in secondary hospitals and tertiary hospitals decreased by 5.60 and 5.66 percentage points,respectively.The consumption of local and nonlocal patients in tertiary hospitals decreased by 6.89 and 8.86 percentage points.In Beijing,the proportion of outpatient services in local secondary hospitals for patients increased from 30.32%to 35.09%,and the proportion of inpatient services increased from43.25%to 52.27%.The proportion of in-patient services in tertiary hospitals for patients with external medical treatment increased to 91.91%after the comprehensive reform of linkage of medical consumption.Conclusion:The comprehensive reform on drug standard and consumption proportion are remarkable,and the flow of patients from different sources of cancer was optimized by comprehensive medical reform,but it is necessary to strengthen the role of primary medical institutions in cancer prevention and treatment and focus on the medical burden of non-local patients in Beijing.

关 键 词：卫生费用核算体系2011 医药分开 医耗联动 肿瘤 

分 类 号：R1-9[医药卫生—公共卫生与预防医学] F224.5[经济管理—国民经济]