出院人次中医药激励政策对“国考”指标协同改善研究——基于间断时间序列分析  

Reserach on the Synergistic Improvement of Traditional Chinese Medicine Incentive Policies on Hospital Performance Assessment Indicators for Number of Discharge Patients Based on Time Series Analysis

作　　者：赵玉洋 吴春华[1] 陈岩[1] 郝晋 徐丹 韩芳 孔令芳 Zhao Yuyang;Wu Chunhua;Chen Yan(Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing,100010,China;不详)

机构地区：[1]首都医科大学附属北京中医医院,北京100010

出　　处：《中国医院管理》2025年第5期63-66,共4页Chinese Hospital Management

基　　金：国家中医药管理局监测统计中心深化医改中医药政策研究自选课题(YGZXKT2024028)。

摘　　要：目的评价出院人次中医药激励政策对住院中医“国考”指标协同改善的初步效果。方法选取某三级甲等中医综合医院2018年10月—2021年10月的分月病案首页明细数据,采用中断时间序列分析方法,以新冠疫情开始时间(2019年12月)、出院绩效方案正式施行时间(2020年9月)作为2个中断点,分析中断点前后出院患者中药饮片使用率、出院患者中医非药物疗法使用率、以中医为主治疗的出院患者占比、住院医疗服务收入占比变化趋势。结果尽管受新冠疫情影响,方案施行后,以中医为主治疗的出院患者占比、出院患者中药饮片使用率、出院患者中医非药物疗法使用率及医疗服务收入占比4项指标均呈正向增长趋势。结论样本医院在出院绩效奖金修订方案增设中医药奖励模块,有效激励了医务人员应用中医药的积极性,使得中药饮片使用率、中医非药物疗法使用率、以中医为主治疗的出院患者占比和医疗服务收入占比均呈上升趋势,表明中医药激励政策对中医医院国考指标具有积极影响。Objective To evaluate the preliminary effects of a Traditronal Chinese Medicine(TCM)incentive policy aimed at the number of discharge patients on the synergistic improvement of performance assessment indicators in the Traditional Chinese Hospital.Methods It selected detailed data from the first page of medical records at the grade A teritary hospital from October,2018 to October,2021.Using the Interrupted Time Series analysis method,two breakpoints were taken as the start time of COVID-19(December 2019)and the official implementation time of discharge performance program(September 2020).The utilization rate of TCM decoction pieces among discharged patients,the utilization rate of TCM non-drug therapy among discharged patients,the proportion of discharged patients mainly treated with TCM,and the proportion of inpatient medical service income before and after the breakpoint were analyzed.Results Despite the impact of COVID-19,after the policy was implemented,four key indicators showed a positive growth trend:the proportion of discharged patients treated primarily with TCM,the rate of TCM decoction use among discharged patients,the rate of TCM non-pharmaceutical therapy use among discharged patients,and the proportion of medical service income,respectively.Conclusion The introduction of a TCM reward module in the discharge performance bonus plan of the sample hospital effectively stimulated the enthusiasm of medical staff in applying TCM.The utilization rate of TCM decoction slices,the utilization rate of TCM non-drug therapy,the proportion of discharged patients treated mainly by TCM and the proportion of medical service income all showed an upward trend,indicating that the incentive policy of TCM has a positive impact on the national examination index of TCM hospitals.

关 键 词：国家三级公立中医医院绩效考核 出院人次 中医药激励政策 间断时间序列分析 

分 类 号：R197.32[医药卫生—卫生事业管理]