摘要
[目的]分析药品零差率政策实施后广西公立医院的运营效果及存在问题,为进一步完善公立医院的改革提供参考。[方法]对2014-2017年广西公立医院门诊和住院患者次均医药费用、人均药费、人均检查费、医院药品收入、财政补助收入以及医院业务量数据进行统计分析,并使用比率分析法分析人均药费、检查费占比及不同收入项目占医院总收入比重情况。[结果]①药品零差率政策实施后药占比下降,门诊药占比由2014年的45.6%下降至2017年的39.6%,住院药占比由34.8%下降至28.4%,而人均检查费占比逐年上升;②门诊及住院患者次均医药费用增长率略有下降,但在2017年药品零差率政策全面铺开时,患者次均医药费用增长率明显反弹;③诊疗人次与入院人数均有较大增长,医生工作量高于全国平均水平,工作负担较重;④医院财政补助收入占医院总收入的比重较低,医疗机构财政补助无法弥补药品零差率政策带来的政策性亏损。[结论]药品零差率改革初见成效,但次均医药费用控制效果不够理想,需探索和构建科学合理的医疗服务价格体系,建立长效财政投入机制,维护医院的公益性质。
Objective To analyze the operation effect and problems after the implementation of drugs zero profit policy so as to provide reference for further perfecting the reform in public hospital of Guangxi province.Methods It conducted statistical analysis on average medical expenses of per outpatient and inpatient,per capita medicine expenses,per capita inspection fees,income of drugs,financial subsidy income and hospital business volume data in Guangxi public hospitals from 2014 to 2017.Results 1.After the implementation of zero profit drugs reform,the proportion of drugs decreased.The proportion of drugs used in outpatient clinics decreased from 45.6%in 2014 to 39.6%in 2017,in hospital decreased from 34.8%to 28.4%,while per capita inspection fee increased year by year.2.The growth rate of average medical expenses of per outpatient and inpatient decreased slightly,but the growth rate of average per patient medical expense rebounded significantly when zero profit drugs reform was fully implemented in 2017.3.The person-time of diagnosis and treatment,the number of hospitalization has increased considerably.The workload of doctors is higher than the national average level,and the workload is heavy.4.The proportion of hospital financial subsidy income to total hospital income is low,and the financial subsidy of medical institutions can not compensate for policy-related losses which caused by zero profit drugs policy.Conclusions The reform of zero profit drugs has achieved initial results,but the control effect of average per medical expenditure is not ideal.It is necessary to explore and build a scientific and reasonable medical service price system,establish a long-term financial investment mechanism,and maintain the public welfare nature of hospitals.
作者
彭蓉
韦小飞
覃娴静
杨翠连
凡滇琳
冯启明
PENG Rong;WEI Xiao-fei;QIN Xian-jing;YANG Cui-lian;FAN Dian-lin;FENG Qi-ming(Health Policy Research Center of Guangxi Medical University,Nanning Guangxi 530021,China;Department of Medical Quality Management and Control of Liuzhou General Hospital,Liuzhou Guangxi 545006,China)
出处
《卫生软科学》
2020年第7期18-22,共5页
Soft Science of Health
基金
广西医科大学特色新型智库调研课题项目(GXMUZK05)。
关键词
药品零差率
公立医院
医疗费用
广西
drugs zero profit
public hospital
medical expenses
Guangxi
