浙江某三甲医院实施省级公立医院综合改革的实证分析

An empirical analysis of a comprehensive reform of a provincial public hospital in Zhejiang

目的以省级三级甲等综合性医院为例，分析和探讨新医改政策执行6个月的实施效果。方法采用趋势分析法、因素分析法、比率分析法等每月进行监测，并就医改前后同期数据进行对比分析，以真实反映执行医改新政对医疗运营的影响。结果医药总收入增长（22．09％）主要是由医疗服务数量增长（22．28％）引起；政策性调价因素使医药总收入下降0．16%；药占比下降4．84％；医改后每门诊人次和每住院人次收入分别增长12．32％和5．35％。结论医院执行药品零差率，上调部分医疗服务收费标准后，医院医药总收入的增长主要是由医疗服务数量增长引起，政策性调价因素影响甚小。新医改有利于优化收入明细结构，提升医生的技术劳务价值。

Objective To analyze implementation outcomes of the new health reform policy at a provincial hospital for the past six months. Methods Trend analysis, factor analysis and ratio analysis approaches were used in monthly surveillance, along with comparative study of the data before and after the reform, to probe into impacts of the new policy on hospital operations. Results Medical income increased by 22. 09%, mainly contributed by volume growth （22. 28^） of medical services; Medical income dropped by 0. 16% due to pricing policy factors; medicine proportion deceased by 4. 84%; following the reform, the income per outpatient and inpatient increased by 12. 32% and 5. 35% respectively. Conclusion Following the ＂drug zero profit＂ policy and rise of the charging standards for medical treatment service at the hospital, the growth of total income mainly comes from growing volume of medical services instead of pricing policy factors. The new health reform is conducive to optimizing the hospital＇s income structure and raising value to doctors＇ technical service.