取消药品加成医疗服务价格调整政策对公立医院的影响——以山东省J医院为例

Analysis on the impact of cancelling drug price addition and adjustment policy of medical service price to public hospital——Take J hospital in Shandong province for example

[目的]分析取消药品加成医疗服务价格调整政策对公立医院收支费用的影响,以评价公立医院取消药品加成医疗服务价格调整政策实施后的效果,为医院精细化管理提供参考依据。[方法]利用医院统计报表导出取消药品加成前、后住院患者的明细,对患者住院、门诊费用结构、医院收支结构和不同科室收治病种等变化情况进行分析。[结果]取消药品加成医疗服务价格调整政策后医院药占比由24. 7%降至22. 5%,但并没有带来医疗费用的下降,医院收支结余出现负增长,常见典型病种显示药占比均降低,病种费用结构趋向合理。[结论]取消药品加成后药品收入在门诊和住院收入中占比均有所下降,医疗价格调整补偿不达预期,应"三医联动"完善医保支付方式,加强公立医院内部管理以促进公立医院的可持续发展。

Objective To analyze the influence of cancelling drug price addiction and adjustment policy of medical service price to the income and expenses of public hospital,evaluate the effect after the implementation of cancelling drug price addiction and adjustment policy of medical service price so as to provide reference for the hospital’ s refined management. Methods It used hospital’ s statistical statement to derive the analysis of the changes of the inpatient’ s detail before and after cancelling drug price addiction,the structure of inpatient’ s and outpatient’s expenditure,the structure of hospital’ s income and expenses and different department treating disease. Results Drug proportion of hospital reduced after cancelling drug price addition and adjustment policy of medical service price,but it didn’ t brought about the reducing of medical expense. The hospital’ s balance of income and expenditure showed a negative growth. Drug proportion of common and typical disease was reduced. Cost structure of disease trended reasonable. Conclusions The proportion of drug income in outpatient and hospitalization has reduced somewhat after cancelling the drug price addition. Medical price adjustment compensation is not up to expectations. It is recommended that to improve medical insurance payment pattern,strengthen internal management in public hospital so as to promote sustainable development of public hospital.