基本药物制度实施前后乡镇卫生院患者就诊费用变化研究

Study on the Changes of Hospitalization Costs for Patients in Township Hospitals before and after the Implementation of Essential Medicine System

目的:以山东省某市乡镇卫生院为例,研究基本药物制度实施对乡镇卫生院患者就诊费用的影响。方法:通过关键指标匹配法,选取7家试点的卫生院为样本,同时选取7家非试点卫生院作为对照,利用1:1配对控制非研究因素对结果的影响,然后采用倍差法研究基本药物制度对卫生院次均住院费用和次均门诊费用的影响。结果:卫生院实施基本药物制度后,通过倍差法控制其他影响因素,次均门诊费用降低61.37元,次均住院费用升高26.66元。次均药品费用降低,其中,门诊降低64.48元,住院降低75.70元;次均医疗费用升高,其中,门诊增长3.12元,住院增长102.36元。结论:乡镇卫生院实施基本药物制度后,患者就诊费用出现"两降两升"。即"门诊费用降低、住院费用升高,药品费用降低、医疗费用升高"。

Objective：Taking a city in Shandong as an example to study the effects of implementing essential medicine system on hospitalization costs for patients in township hospitals.Methods：Through key indicator matching method,7 pilot health centers were chose as samples, while 7 non-pilot health centers were chosen as the control. According to the effects of using 1：1 matching control non-experimental factor,difference in difference method was used to analyze the effects of essential medicine system on average hospitalization cost per time in health centers and average outpatient cost per time.Results：After implementing essential medicine system in health centers, difference in difference method was used to control other effecting factors, average outpatient costs per time decreased by 61.37 yuan,average hospitalization cost per time increased by 26.66 yuan. Average medicine cost increased,outpatient cost increased by 3.12 yuan,hospitalization cost increased by 102.36 yuan.Conclusion：After the implementation of essential medicine system in township health centers,patients＇ medical costs appeared＂two decrease,two rise＂,known as＂outpatient costs decreased,hospitalization costs increased,medicine costs decreased,medical costs increased＂.