摘要
目的:对新医改中河南省综合医院门诊人均费用结构变动的特征与趋势进行分析,为有效控制门诊费用快速增长、完善诊疗机制提供参考依据。方法:通过河南卫生计生年鉴以及河南省国民经济和社会发展统计公报,收集河南省综合医院2014-2017年门诊病人人均费用资料,采用结构变动度进行分析。结果:2014-2017年综合医院门诊病人人均费用占比中,药费占比最高,总体结构变动度为3.02%,整体变动不大,变动值均呈正向变动的为化验费和卫生材料费,检查费则呈先负后正变动;化验费、检查费和卫生材料费对门诊费用结构的贡献率和拉动力均处于前3位。结论:河南省综合医院门诊病人人均总费用增速上升,化验费和卫生材料费占比逐年上升,药占比居高不下,同时存在费用转移现象;诊察费、手术费和卫生服务费等收入项目比重低,不利于体现从业人员技术劳务价值,费用结构不尽合理。医院应进一步调整收入结构,加强药品监管,改革薪酬制度,完善激励机制,坚持公平性、科学性和导向性的统一。
Objective:To analyze the characteristics and trend of outpatient expenditure structure changes in Henan General Hospital during the new medical reform,and to provide reference for effectively controlling the rapid growth of outpatient expenditure and improving the diagnosis and treatment mechanism.Methods:Through Henan health and family planning yearbook and national economic and social development statistical bulletin,data of per capita cost of outpatients in Henan General Hospital from 2014 to 2017 were collected and analyzed by structural change degree.Results:In the proportion of per capita expenditure of outpatients in general hospitals from 2014 to 2017,the proportion of drug expenditure was the highest,with the overall structural change of 3.02%.The overall change was not significant.The change values showed positive changes for laboratory fee and health material fee,while the inspection fee showed negative first and then positive change.The contribution rate and pulling power of laboratory fees,inspection fee and health material fee to outpatient expenditure structure were in the top three.Conclusion:The per capita total expenditure of outpatients in Henan General Hospital has increased,the proportion of laboratory fee and health material fee has increased year after year,and the proportion of drugs has remained high.At the same time,therewas a phenomenon of cost transfer.The low proportion of income items such as consultation fee,operation fee and health service fee waas not conducive to reflecting the value of technical services of employees,and the cost structure was unreasonable.Hospitals should further adjust the income structure,strengthen drug supervision,reform salary system,improve incentive mechanism,and adhere to the unity of fairness,scientificity and orientation.
作者
田召召
薛浩
蒋淑敏
张晓星
李雪文
张彦茹
朱伟
Tian Zhaozhao(School of Public Health,Zhengzhou University,Zhengzhou,450001)
出处
《医学与社会》
北大核心
2019年第10期80-83,97,共5页
Medicine and Society
基金
世界银行贷款项目(TCC6)“河南省医养结合政策、机制及模式研究”,编号为20180430A
关键词
门诊费用
结构变动度
综合医院
河南
Outpatient Expenditure
Structural Change Degree
General Hospital
Henan
