珠海市某三甲医院药品和医用耗材零差率政策实施效果分析
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摘要
目的:评估药品和医用耗材零差率政策对医院的影响。方法:运用描述性统计和对比分析方法,对珠海市某三甲医院2014年4月~2017年3月的部分业务指标、盈亏测算、患者次均费用进行分析。结果:零差率政策实施两年后,珠海市某三甲医院门急诊人次、普通门诊人次下降。平均住院日为8.88 d,药占比为34.10%。专家门诊人次、出院人次、手术治疗占比增加。虽让利患者,但次均费用仍然增长;医院存在政策性亏损。结论:改革促进了分级诊疗政策的实施,优化了医院收入结构,药占比显著降低,一定程度上达到政策设计的初衷。
Objective: To assess the impact of zero makeup policy for drug and medical supplies on hospitals. Methods: Descriptive statistics and comparative analysis were used to analyze the related indicators,profit and loss calculation and the cost of patients from April 2014 to March 2017. Results: After the policy was implemented,the number of outpatients and the number of outpatients choosing general doctors decreased. The average length of hospitalization was 8. 88 days,and the proportion of drug consumption was 34. 10%. The number of outpatients choosing medical experts,the number of inpatients and the proportion of surgical treatment increased. Although the policy benefited patients,the average medical expenditure still increased. There was policy loss in the hospital.Conclusion: The reform promotes the implementation of hierarchical medical system,optimizes the hospital income structure and reduces drug proportion significantly,which achieves the original intentions of the policy to some extent.
Objective: To assess the impact of zero makeup policy for drug and medical supplies on hospitals. Methods: Descriptive statistics and comparative analysis were used to analyze the related indicators,profit and loss calculation and the cost of patients from April 2014 to March 2017. Results: After the policy was implemented,the number of outpatients and the number of outpatients choosing general doctors decreased. The average length of hospitalization was 8. 88 days,and the proportion of drug consumption was 34. 10%. The number of outpatients choosing medical experts,the number of inpatients and the proportion of surgical treatment increased. Although the policy benefited patients,the average medical expenditure still increased. There was policy loss in the hospital.Conclusion: The reform promotes the implementation of hierarchical medical system,optimizes the hospital income structure and reduces drug proportion significantly,which achieves the original intentions of the policy to some extent.
引文
1周晓爽,李婷婷,顾雪非,等.基本药物零差率销售对降低医药费用的影响研究[J].中国卫生经济,2013,32(8):50-52
2 周忆南,蔡卫民.上海市部分医疗机构药房托管调研与可行性分析[J].中国药师,2015,18(3):446-448
3 王洪锐,李文祯,李东,等.社区居民对国家药物制度实施情况的满意度调查[J].中国药师,2013,16(7):1015-1017
4 方洁,邓丽琼,林双宏.医药分开对医院职工收入的影响分析[J].中国卫生经济,2013,32(5):63-64
5 张建琴,卢丽娟,张幸国,等.浙江省县级医疗机构药品零差率对其经济运营的影响[J].中国卫生经济,2015,34(3):71-73
6 岳经纶,王春晓.堵还是疏:公立医院逐利机制之破除——基于广东省县级医院实施药品零差率效果分析[J].武汉大学学报(哲学社会科学版),2016,69(2):29-38
7 吕程,解彦.珠海某三甲医院实施药耗“零差率”的实证研究[J].管理观察,2017,(13):182-184
8 齐新红,董新文,李建文,等.药品零差率下新疆各级公立医疗机构医疗服务价格调整方案[J].中国卫生经济,2011,30(6):43-45
9马洪兰.实施药品零差率对天津市三级医院影响的预测分析[J].中华医院管理杂志,2012,28(5):329-332
10 国务院办公厅.关于城市公立医院综合改革试点的指导意见[Z].国办发[2015]38号.2015-05-06
2 周忆南,蔡卫民.上海市部分医疗机构药房托管调研与可行性分析[J].中国药师,2015,18(3):446-448
3 王洪锐,李文祯,李东,等.社区居民对国家药物制度实施情况的满意度调查[J].中国药师,2013,16(7):1015-1017
4 方洁,邓丽琼,林双宏.医药分开对医院职工收入的影响分析[J].中国卫生经济,2013,32(5):63-64
5 张建琴,卢丽娟,张幸国,等.浙江省县级医疗机构药品零差率对其经济运营的影响[J].中国卫生经济,2015,34(3):71-73
6 岳经纶,王春晓.堵还是疏:公立医院逐利机制之破除——基于广东省县级医院实施药品零差率效果分析[J].武汉大学学报(哲学社会科学版),2016,69(2):29-38
7 吕程,解彦.珠海某三甲医院实施药耗“零差率”的实证研究[J].管理观察,2017,(13):182-184
8 齐新红,董新文,李建文,等.药品零差率下新疆各级公立医疗机构医疗服务价格调整方案[J].中国卫生经济,2011,30(6):43-45
9马洪兰.实施药品零差率对天津市三级医院影响的预测分析[J].中华医院管理杂志,2012,28(5):329-332
10 国务院办公厅.关于城市公立医院综合改革试点的指导意见[Z].国办发[2015]38号.2015-05-06
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