2018—2020年辽宁省中医类医院经常性卫生费用分析

Analysis of Recurrent Health Costs in Liaoning Province Traditional Chinese Medicine Hospitals from 2018 to 2020

目的:通过了解2018—2020年辽宁省中医类医院经常性卫生费用的总量分布,从服务功能、受益人群、筹资结构等维度对其进行分析,以期为中医药政策的制定提供理论指导。方法:利用“卫生费用核算体系2011”(SHA2011),采用多阶段分层随机抽样方法抽取获得样本数据,结合样本数据和辽宁省卫生行政相关数据,利用等值人时系数、等值工作量系数核算出2018—2020年辽宁省中医类医院经常性卫生服务费用。结果:2018—2020年辽宁省中医类医院经常性卫生服务费用分别为131.06亿元、134.07亿元和139.29亿元,其中治疗服务费用分别为131.02亿元、134.03亿元和139.25亿元,预防服务费用均为0.04亿元。省级中医类医院经常性卫生服务费用最高,区级最低。筹资来源主要为公共卫生筹资的社会基本医疗保险。50~69岁人群、非传染性疾病(尤其是循环系统疾病)为治疗服务费用的重点关注领域。结论:辽宁省应优化中医费用层级,实现省级医疗资源下沉;加强公共筹资方案的主导作用,降低家庭卫生支出占比;分析费用的服务功能和受益人群,实现精准专项救济。

OBJECTIVE By understanding the total distribution of recurrent health costs,service functions,beneficiary population,and funding structure of TCM class hospitals in Liaoning Province from 2018 to 2020,we can better provide theoretical guidance for TCM policies.METHODS Using the System of Health Accounts 2011(SHA2011),the sample data were obtained by multi-stage stratified random sampling method,and the recurrent health costs of Chinese medicine class hospitals were accounted for by combining the sample data and data from relevant departments of health administration in Liaoning province using the equivalent man-hour coefficients and equivalent workload coefficients.RESULTS The recurrent health service costs of TCM class hospitals in Liaoning province from 2018 to 2020 were 13.106 billion yuan,13.407 billion yuan and 13.929 billion yuan,of which 13.102 billion yuan,13.403 billion yuan and 13.925 billion yuan were for treatment services and 0.04 billion yuan,0.04 billion yuan and 0.04billion yuan were for preventive services.The highest recurrent health costs were at the provincial level for Chinese medicine category hospitals and the lowest at the district level.Financing was mainly from the basic social health insurance financed by public health.50~69 years old age group,non-communicable diseases,circulatory system diseases are the key areas of concern for the cost of treatment services.CONCLUSION Optimizes the cost hierarchy of Chinese medicine to realize the sinking of provincial resources;strengthens the leading role of public financing programs to reduce the proportion of family health expenditures;analyzes the service function and beneficiary population of costs to realize precise special relief.