社区卫生收支两条线改革对门诊处方费用的作用研究

Impact of Separation of Income and Expenditure Reform on Prescription Fee in Community Health Service Organizations

目的评估社区卫生收支两条线改革对陶然亭社区卫生服务中心门诊处方费用的作用效果。方法收集陶然亭社区卫生服务中心在收支两条线改革前、后的电子门诊处方作为研究样本,利用多元回归模型评估改革的作用效果。结果在控制了慢性病及季节因素后,收支两条线改革使次均处方费用下降了17.8%(P<0.001),其中诊疗费用下降了29.0%(P<0.001),药品费用下降了5.3%(P=0.012)。结论社区卫生收支两条线改革降低了次均处方药品费用、诊疗费用及次均处方费用,减轻了患者的就医负担。

Objective To evaluate the impact of Separation of Income and Expenditure Reform on prescription fee in Taoranting community health services center. Methods The electronic prescriptions in outpatient department of Taoranting community health services center before and after the implementation of Separation of Income and Expenditure Reform were collected as the study samples,and the multiple regression model was taken to identify the impact of the reform. Results Through the reform,average fee per prescription decreased by 17.8%（P0.001） after controlling the confounding such as chronic disease and season;of which the average examination and treatment fees decreased by 29.0%（P0.001） and the average drug fee decreased by 5.3%（P=0.012）. Conclusion Separation of Income and Expenditure Reform reduces the average amount of drugs per prescription,examination and treatment fees,and average fee per prescription,so it can reduce the burden of patient.