摘要
目的:分析海南省公立医院门诊次均费用结构变动情况,为控制公立医院医疗费用过快增长提供参考依据。方法:通过海南省医改监测直报系统提取2017-2021年公立医院门诊费用相关数据,采用结构变动度等指标进行分析。结果:2017-2021年海南省公立医院门诊次均费用总体增速放缓,年均增长率为1.74%,总体结构变动度为14.87%,整体结构变动较明显;体现医务人员技术劳务价值的诊察费、治疗费、手术费等占比有不同程度的提高,治疗费、手术费结构变动值呈正向变动,药品费、检查费、卫生材料费等占比和结构变动贡献率不断下降,药占比仍保持在40%左右;化验费占比明显提升,结构变动贡献率和拉动力均位于首位。结论:海南省公立医院综合改革工作取得一定成效,初步实现控费目标;门诊次均费用结构得到明显改善,但仍有待优化,需持续加强药品费用管控,重点关注化验类收入,避免出现费用转移现象;同时,进一步提高对医务人员技术劳务价值的重视程度,增强工作积极性。
Objective:To analyze the changes of the average outpatient expenditure structure of public hospitals in Hainan province,so as to provide reference for controlling the rapid increase of medical expenditure in public hospitals.Methods:Through the direct reporting system of Hainan medical reform monitoring,the relevant data of outpatient expenditure of public hospitals from 2017 to 2021 were collected and analyzed by using indicators such as degree of structure variation.Results:From 2017 to 2021,the average outpatient expenditure of public hospitals slowed down,with an average annual growth rate of 1.74%.The overall structure degree of the average outpatient expenditure had a significant change,and the overall structure change degree was 14.87%.The proportion of examination fee,treatment fee and operation fee reflecting the value of medical personnel's technical labor increased to varying degrees.The structural change values of treatment fee and operation fee showed positive changes,while the proportion and structural change contribution rate of drug fee,inspection fee and health material fee showed negative changes all the time,and the proportion of drugs still maintained at about 40%.The proportion of laboratory fee increased obviously,and the structural change contribution rate and pulling force of it were in the first place.Conclusion:The comprehensive reform of public hospitals in Hainan province has achieved good results and initially achieved the goal of expenditure control.The average outpatient expenditure structure has been significantly improved,but still needs to be further optimized.It is necessary to continuously strengthen the control of drug expenditure,and pay attention to the income of diagnostic test services to avoid the phenomenon of the expenditure transfer.At the same time,the emphasis of the value of the medical staff's technical services should be further enhanced,thus increasing their working enthusiasm.
作者
杨梦喆
杜洁
张新花
张毓辉
YANG Mengzhe(School of Humanities and Social Sciences,Guangxi Medical University,Nanning,Guangxi,530021,China)
出处
《医学与社会》
北大核心
2023年第9期109-114,共6页
Medicine and Society
基金
国家自然科学基金资助项目,编号为71874039。
关键词
医院管理
门诊费用
公立医院
结构变动
海南
Hospital Management
Outpatient Expenditure
Public Hospital
Structure Variation
Hainan
