不同财政补助水平下县级公立医院经济运行情况分析

Impact of financial subsidy on business operations at county-level public hospitals

目的分析补偿机制改革中不同财政补助水平下，2014年试点县级公立医院经济运行状况。方法在全国东、中、西部各抽取2个省（自治区），遴选109个试点县的县级公立医院，通过描述性分析及相关分析，比较不同财政补助比例下医院经济运行情况。结果2014年，不同财政补助比例下，县级公立医院收支情况存在差异。随着补助比例的加大，医院年均工作总当量减少（P〈0．01），患者次均住院费用减少（P=0．01），药占比下降（P0．01）。结论财政补助与县级公立医院财务平衡及经济运行有一定的关联性。建议落实政府投入责任，建立财政补助的长效保障机制。

Objective To learn the business operations of the pilot county-level public hospitals chosen for the 2014 experiment, which were subsidized at different levels in the financial subsidy mechanism reform. Methods County-level public hospitals from 109 counties were sampled as pilots from two provinces of the eastern, central and western regions of China. Descriptive analysis and correlation analysis were made to study their business operations at various subsidy levels. Results Proportional differences in the governmental financial subsidy level make a difference in the revenue and expenditure of county-level public hospitals. The higher the subsidy proportion, the lower the annual average of the total workload of the hospital（P〈0.01）, the less the inpatient expenditure per hospitalization（P=0.01）, and the lower the drug proportion as well（P〈0. 01）. Conclusions Financial subsidy plays a key role in the financial balance and business operation of such hospitals. Hence the government is proposed to guarantee its financial subsidy responsibility, to build a long-term financial subsidy mechanisrrL