摘要
目的分析医改前后住院患者住院费用指标变化情况,为今后医改政策制定和医院改革方向的把握提供参考依据。方法选择医改后2019年6月15日-2019年12月31日与医改前2018年6月15日-2018年12月31日的住院患者住院费用及基本医疗指标数据,利用描述统计方法、假设检验方法和卡方检验方法进行差异性分析。结果医改后出院人数增长16.62%,平均住院日降低了0.82天,术前住院日降低了0.36天,手术例数增长11.74%。例均住院总费用由医改前的21492.11元降至改后的20283.73元,差异有统计学意义,P<0.05。其中住院患者材料费、药费、检验费、放射费、超生费均有不同下降,手术费、麻醉费、病理费、监护及辅助呼吸设备费均有不同上升,差异具有统计学意义,P<0.05。材料占比由医改前的43.05%,下降至医改后40.68%,药占比由医改前23.54%,下降至医改后22.41%。结论医改后住院各项费用有针对性调整、有升有降,本次医改告别了以往医院以耗养医、以药养医的历史,重新建立了科学合理的医疗机构收入补偿机制,符合医耗联动改革政策。
Objective To analyze the changes of inpatient cost index before and after the medical reform,and to provide reference for the future medical reform policy-making and hospital reform direction.Methods The data of inpatients’hospitalization expenses from June 15,2019 to December 31,2019 after the medical reform and from June 15,2018 to December 31,2018 before the medical reform were selected,and the differences were analyzed by descriptive statistics,hypothesis test(central limit theorem)and chi square test.Results After the reform,the number of discharged patients increased by 16.62%,the average length of stay decreased by 0.82 days,the preoperative length of stay decreased by 0.36 days,and the number of surgical patients increased by 11.74%.The total cost of inpatients decreased from 21492.11 yuan before the medical reform to 20283.73 yuan after the first medical reform,the difference was statistically significant(P<0.05).The material cost,drug cost,inspection cost,radiation cost and over birth cost of inpatients decreased differently,while the operation cost,anesthesia cost,pathology cost,monitoring and auxiliary respiratory equipment cost increased differently,the difference was statistically significant(P<0.05).The proportion of materials decreased from 43.05% before the medical reform to 40.68% after the medical reform,and the proportion of drugs decreased from 23.54%before the medical reform to 22.41% after the medical reform.Conclusion After the medical reform,the hospitalization expenses have been adjusted,increased and decreased.This medical reform bid farewell to the past history of hospitals supporting doctors by consumption and medicine,and re established a scientific and reasonable income compensation mechanism of medical institutions,which is in line with the reform policy of medical consumption linkage.
作者
牛犇
张红卫
Niu Ben;Zhang Hongwei(Beijing Luhe Hospital affiliated to Capital Medical University,Beijing 101149,China;不详)
出处
《中国病案》
2021年第10期57-60,共4页
Chinese Medical Record
关键词
医耗联动
医改
药占比
耗占比
Linkage of medical consumption
Medical reform
Proportion of drugs
Proportion of consumption
