摘要
目的:为了解县级公立医院药品零加成改革措施实施后医疗费用及相关医疗行为的变化。方法:抽取3个试点县的综合性医院各1所,比较改革前后它们的剖腹产、单纯性阑尾炎切除术和单纯性胆囊摘除术等3个病种手术在手术数量、均次医疗费用和费用结构等方面的变化,分析改革对医疗行为的影响。结果:3个病种的手术数量、均次医疗费用在改革后的变化趋势与不同医院有关,但在费用结构上则均呈现优化,药品费用比重下降,手术费用比重上升。结论:改革措施促进了医疗费用结构的优化,未发现所调查的病种有分解住院现象,但需及时调整均次费用零增长要求,进一步深化改革,利用支付方式引导医疗行为。
Objective To study the changes of medical expenses and medical behaviors in county state-owned hospitals after the reform of non-profit-drug. Methods Every one comprehensive hospital was selected from 3 pilot counties. The amount of surger- ies, average medical costs and structure of medical cost of three diseases before and after reform were comparatively analyzed. Results The change of the amount of surgeries and average medical costs of three diseases after reform was different in different hospitals. However, the structure of medical costs was optimized,in which the ratio of drug cost decreased with the increased ratio of surgery cost. Conclusion Reform of non-profit-drug has promoted the optimization of medical expense structure. It is suggested to adjust the requirements of zero growth of medical cost, and reform the payment mode to guide medical behaviors.
出处
《中国卫生事业管理》
北大核心
2014年第5期335-337,共3页
Chinese Health Service Management
基金
浙江省哲学社科规划课题"县级公立医院药品零差率改革对医疗行为的影响研究"(编号:12XKGJ25)
关键词
县级公立医院
药品零加成改革
医疗行为
病种费用
county state-owned hospitals
reform of non-profit-drug
medical behaviors
group-based cost.
