浅析外来就医对上海市医疗服务体系的影响

Analysis on the impact of non-residents' medical service utilization on medical services system of Shanghai

上海市作为区域医疗服务中心接受了大量外来就医患者。2012年,上海市外来就医出院人数占全市出院人数的22.7%,住院费用占比达到26.2%,外来患者主要来源于江苏、浙江、安徽,主要流向三级医院,次均医疗费用负担普遍高于全市平均水平。外来就医一方面客观上推动了上海的社会经济发展,增加了医疗机构收入,促进医疗技术水平和资源配置效率提升;另一方面也对本地居民的医疗服务可及性造成了一定影响,触及到医疗服务的公平性等问题。

As a regional medical center,Shanghai is confronting an escalating number of patients from other provinces and cities. In 2012,the number of non-residents’ inpatient stays accounted for 22.7%of total number of inpatient stays and 26.2%of total inpatient expenditure in Shanghai. The non-residents’ patients mainly came from Jiangsu,Zhejiang and Anhui province. They usually sought treatment in tertiary hospitals. Their medical expenses were generally higher than the average. Non-residents’ care-seeking promotes the social and economic development in Shanghai by increasing the revenue of Shanghai’s health institutes and improving medical technology and efficiency of resource allocation. On the other hand,the local residents’ accessibility was influenced,which raised the equity issue of health services.