广东省30种病种成本与费用的实证分析

Empirical Analysis of Cost Calculation Framework for Disease of 30 Kinds' Diseases in Guangdong Province

目的:了解30个病种在本省同一地区不同级别医院同一病种的社会平均成本水平,分析成本与费用之间关系。方法:收集省内21家医院2009年30种病种费用与成本测算相关数据,采用统计描述的方法了解病种费用与成本水平。结果:(1)病种的费用水平离散、高低差异较大,特别是非手术类病种表现更为突出;(2)病种价格水平普遍低于成本水平,反映出当前医疗收费价格与成本之间存在一定程度的背离;(3)三级医院病种损益亏损幅度低于二级医院;(4)药品、材料、人力和管理成本构成了病种主要成本。结论:按照价格的本质确定病种付费标准,并分地区、分医院逐步推行按病种付费工作,同时统一全省医院成本核算系统是解决医疗服务价格缺乏成本基本的有力工具。

Objective： To provide pricing basis for the DRGs reform,this paper studies the average cost and the relationship of cost and fee of 30 diseases in different hospitals in Guangdong.Methods： Collecting the data of 2009 from 21 hospitals in Guangdong Province and using the method of statistical description to understand the disease cost and cost level.Results：（1）Disease cost level discrete,difference is bigger,especially the operation category of diseases are more prominent;（2）disease price level is generally lower than the cost level,and reflects the current medical service price and cost between the presence and degree of deviation;（3）the loss of big hospital is lower than small hospital;（4）drugs,material,manpower and management costs constitute the major cost of disease.Conclusion： According to the essence of the price,disease payment standard is determined,DRGs is introduced gradually,and the hospital cost accounting system is unified so as to solve the lack of cost of medical service price basic tool.