医改前后某综合医院住院费用初步分析

Expenses preliminary analysis for a comprehensive hospital before and after reform

目的探讨某综合医院医改前后住院费用的住院费用基本特征如年龄、性别和不同医保类别的变化特点,为该综合医院制定医改政策和改进医院管理效果提供一定参考依据。方法采用整群抽样的方法分别综合医院对2008年(医改前)和2011年(医改后)181 316份住院费用及其前后变化进行初步分析。将住院患者按照10岁一个年龄段分为9组。结果总医疗费用任何维度来看,全部为增加,增幅达34.94%。次均费用中年龄段中除≥80岁组外,次均费用均为减少,总降幅为4.45%,≥80岁组增幅为14.20%。总费用及费用分类中,男性和女性的西药费降低最多,达2651.02元和1324.55元,增长最多的是材料费,分别为1099.12元和904.93元,医改前后男性均高于女性,医改后实际值差别最大为西药费,达2920.88元,相差幅度最大的为化验费相差57.34%。结论全国医疗体制改革确实减少了该医院患者某些住院项目费用负担,应进一步分析具体费用及其影响因素,为进一步进行医改提供决策依据。

Objective To investigate the characteristics changes, such as age, gender and different health care category of hospitalization expenses and hospitalization expenses of basic characteristics of health care in a hospital, and provide a reference for the hospital for medical reform policy to improve the management of hospitals. Methods From 2008 （health care before） by cluster sampling method were integrated hospital and 2011 （after the reform） carried out a preliminary analysis of 181 316 hospitalized expense and its changes. The hospitalized patients under the age of 10 ages were divided into 9 groups. Results The total medical costs of any dimension increased, with an increase of 34.94%. The average cost of age except 980 years old group, second all expenses were reduced, the total fell to -4.45%, an increase of ≥ 80 years old were 14.20%. The total cost and expense classification, male and female drug costs decreased most, reached 2651.02 yuan and 1324.55 yuan, growth was the most material fee, with 1099.12 yuan and 904.93 yuan respectively before and after medical reform, men were higher than women, after the reform, the actual value was the most different medicine fee of 2920.88 yuan, the biggest difference was laboratory with fee of 57.34%. Conclusion The national health care system reform do reduce some hospital project cost burden of the hospital patient, further analysis of specific costs and its influencing factors need be given, to provide the theoretical basis for further reform.