医药分开与医耗联动综合改革对北京市某区医疗服务收入及其结构的影响——基于RDiT实证研究  

The impact of the separation of medicine and pharmacy and the integrated reform of medical expenses on medical service revenue and its structure in a district of Beijing: an empirical study based on RDiT

作　　者：杨辉 YANG Hui(Shunyi District Hospital,Beijing 101300,China)

机构地区：[1]北京市顺义区医院,北京101300 [2]北京市顺义区卫生和健康委员会,北京101300

出　　处：《现代预防医学》2025年第1期108-113,119,共7页Modern Preventive Medicine

摘　　要：目的 分析医药分开和医耗联动综合改革对北京市某区医疗服务收入的影响。方法 利用2016年1月—2024年4月的监测数据,构建时间断点回归模型进行分析。结果 医药分开改革实施后,二、三级医院的医疗服务收入占比和门急诊次均医疗服务收入得到显著提升(P<0.05)。医耗联动改革实施后,二级医院门急诊次均医疗服务收入和服务收入占比得到显著提升(P<0.05)。结论 改革实施后医疗服务收入总量和占比得到显著提升,收入结构进一步优化,技术劳务价值得到更加充分体现。但医疗服务收入占比还比较低,建议完善改革联动机制,强化医疗服务监管,推动医疗资源均衡分布,重点加强基层医疗机构服务能力提升。Objective To analyze the impact of the separation of medicine and pharmacy and the integrated reform of medical expenses on medical service revenue in a district of Beijing.Methods Utilizing monitoring data from January 2016 to April 2024,a time breakpoint regression model was constructed for analysis.Results Following the implementation of the separation of medicine and pharmacy reform,the proportion of medical service revenue and the average medical service revenue per visit in secondary and tertiary hospitals significantly increased(P<0.05).After the implementation of the integrated reform of medical expenses,the average medical service revenue per visit and the proportion of service revenue in secondary hospitals also saw significant increases(P<0.05).Conclusion After reform,the total amount and proportion of medical service revenue have significantly increased,with further optimization of the revenue structure and a more adequate reflection of the value of technical services.However,the proportion of medical service revenue remains relatively low.It is recommended to enhance the reform linkage mechanism,strengthen the supervision of medical services,promote the balanced distribution of medical resources,and focus on improving the service capacity of primary healthcare institutions.

关 键 词：医药分开 医耗联动 时间断点回归 医疗服务收入 

分 类 号：R197.3[医药卫生—卫生事业管理]