某市公立医院门诊和住院收入影响因素的动态分析

Dynamic Factors Analysis of Outpatient and Inpatient Income in Public Hospitals in a City

目的探讨某市公立医院门诊和住院收入增长的主要影响因素,为有效控制医疗费用过快增长提供依据。方法采用指数体系因素分析法对某市14家公立医院2012年-2014年总体收入情况进行分析。结果 2012年-2014年某市公立医院门诊和住院人次、次均费用、收入均呈逐年增长趋势;2013年-2014年门诊次均费用上涨成为影响门诊收入增加的主要因素,药费的影响程度仍然是6项(药费,卫生材料费,化验费,检查费,挂号、诊察费,手术、治疗等费用)次均费用构成中最高,但影响程度较2012年-2013年段略有下降,而检查费的影响程度增长较快;2013年-2014年住院检查费的影响程度较2012年-2013年增长最多,药费的影响程度下落明显。结论次均费用在收入增加方面起着主导作用,而医院检查费用在次均费用结构中增长最快,提示医院可能在政府缺乏健全的补偿机制下而开展鼓励趋利行为的检查项目,政府应健全合理的补偿机制,强化医院公益性,医院应转变管理思路,规范医疗行为。

Objective In order to support the basis of cost control of medical expenses, this article is aimed to analyze and discuss about the main factor affecting revenue of public hospitals in a city. Methods Analyze the overall income of public hospitals during 2012~2014 by using index factor analysis. Results The outpatient and inpatient visits, income, average fee during 2012~2014 were shown an increase tendency. The growth of outpatient average fee was the main factor affecting outpatient income. The effect of drugs was still the highest part in the six average fee during 2013~2014, but it had a lower impact than 2012~2013, by contrast, the impact of the medical examination fee was growing more rapidly. The effect of medical examination fee during 2013~2014 was rising fastest and the effect of drugs decreased obviously. Conclusion The average fee was playing a leading role and the cost of medical inspection grew most quickly, it indicated that hospital will encourage more medical examinations under lacking a sound compensation mechanism; The government should improve the compensation mechanism, in order to maintain public welfare of the hospital; The hospital should improve resource utilization and cost savings, persisting in reasonable check.