结构变动度在我省中医医疗机构门诊医疗费用构成分析中的应用

Application of degree of structure variation in the outpatient medical expense composition analysis of traditional chinese medical institutions in Sichuan

目的探讨该省中医医疗机构门诊医疗费用构成变化情况,以了解导致该省中医医疗机构近年来门诊医疗费用增长的主要因素。方法采用结构变动度指标,分析5年来该省中医医疗机构门诊医疗费用构成变动的情况。结果该省2009年至2013年引起门诊医疗费用结构变化较大的因素有:化验费、检查费、药费;而诊察费、检查费是引起门诊医疗费用结构变动上升的主要费用项目,二者的累积贡献率达到50%;药费、治疗费、化验费是引起门诊医疗费用结构变动下降的主要项目,三者的累计贡献率达到42.43%。结论该省中医医疗机构门诊医疗费用的增长仍然存在结构不合理情况,需要进一步控制药费比,同时提高体现医务人员劳动价值的费用占比。

Purpose The paper discusses the changes in the outpatient medical expense composition of traditional Chinese medical institutions in Sichuan in a bid to identify the principal factors that cause the increase in the outpatient medical expenses of traditional Chinese medical institutions in Sichuan in recent years. Method The index of degree of structure variation(DSV) is adopted to analyze the changes in the outpatient medical expense composition of traditional Chinese medical institutions in Sichuan in recent 5 years. Result Factors bringing about relatively large changes in the outpatient medical expense structure of the province during 2009-- 2013 include assay fee, examination fee, medicine expense, and diagnosis fee. The diagnosis and examination fees are major items causing the rise of outpatient medical expenses, both accumulatively contributing up to 50%; medicine expense and treatment and assay fees, accumulatively contributing 42.43%, are main items causing the decline of outpatient medical expenses. Conclusion The problem of irrational structure still exists in the increase of outpatient medical expenses of traditional Chinese medical institutions in Sichuan. It is recommended to further control the medicine expense rate and increase the proportion of expense reflecting the labor value of medical personnel.