江苏省县级公立医院价格综合改革效果初探

Research on the comprehensive pricing reform at county-level public hospitals in Jiangsu province

目的探讨江苏省医药价格综合改革成效及存在的问题。方法通过对江苏省15个试点县28所试点医院医药价格综合改革前后的经济运行情况、药占比、患者费用等数据进行比较，分析价格改革对医院和患者的影响。结果2012年至2014年，28所医院同期（16月）业务收入和服务量继续保持较快增长，药占比有所下降，但患者门急诊次均费用没有下降。与上一年同期数据相比，2013年和2014年医院总收入增幅分别为13．4％和11．1％，药占比分别为44．9％和42．3％；患者门急诊次均费用增幅分别为5．9％和3．1％。结论江苏省县级公立医院医药价格综合改革已显初步成效，但仍需进一步理顺价格体系，建立合理的价格形成机制，并协同推进相关改革。

Objective To study the outcomes and problems of comprehensive medical pricing reform in Jiangsu. Methods The business operations,drug proportion and patient＇s expenses of 28 pilot hospitals in 15 counties of the province before and after the reform were compared, to learn the impacts of the pricing reform on both hospitals and patients. Results Medical revenue and medical service quantity of these hospitals during this period（January to June） of 2012 2014 maintain a fast growth, with lower drug proportions, and patients＇ expenditure unchanged. Compared with data of the same period in 2012, the total revenue growth rates of the hospitals in 2013 and 2014 were 13.4% and 11.1% respectively; and their drug proportions were 44. 9% and 42.3%; and the expenditure growth rates for outpatient/ emergency service were 5.9 % and 3.1% respectively. Conclusions The reform has achieved an initial success. However the pricing system, needs to be further rationalized to build a better price formation mechanism, in line with relevant reforms.