两种医疗付费方式对门诊患者就诊及用药的影响

The effects of two types of health-payment system on drug use in outpatients of General Hospital of Chinese PLA

目的:对比公费和自费两种医疗付费方式对解放军总医院门诊患者就诊及用药情况的影响。方法:随机抽取门诊取药患者的处方,然后进行统计和分析。结果:两种医疗付费方式患者在神经科、心内科、呼吸科等科室的就诊数量都居前几位。因自费患者受药费支付能力的限制,联合用药中服用1～2种药品的自费患者占76．1％,而公费患者仅占28．6％;就诊科室数目98．9％的自费患者就诊单一科室,而21．6％的公费患者就诊两个或两个以上的科室。结论:两种医疗付费方式对本院门诊患者的就诊及用药有着较大的影响。

Objective： To compare the effects of two types of health-payment system on drug use in outpatients of General Hospital of Chinese PLA. Methods： The prescriptions of outpatients were randomly taken and analyzed. Results： The numbers of patients of both systems visiting the departments of neurology, cardiac disease and respiration occupied several top places. Because of difference of the ability of payment, prescriptions of single drug or combination of 2 kinds of medicine accounted for 76.1% in patients at one＇s own expense, whereas it was only 28.6% in patients at free medical service. About 98. 9% of patients at one＇s own expense visited only one department, while 21.6% of patients at free medical service visited two or more departments. Conclusion： There are considerable effects of these two types of health-payment system on drug use of patients in this hospital.