新医保政策实施前后医院门诊数据分析

Data Analysis of Outpatient Department before and After the Application of New Health Insurance Policy

目的了解新医保政策实施对广州市南部某区属三级甲等综合医院门急诊情况的影响。方法整理某医院2013年-2016年新医保政策实施前后的门急诊诊疗量数据,应用秩和检验和卡方检验分析新医保政策实施前后的体量、增长率及门急诊构成比变化。结果某院新医保政策实施后两年的总诊疗量为434.14万人次,总诊疗量月增幅为0.06%(-2.70%~3.76%),较实施前明显收窄(P=0.007)。专科门诊量为7.94(7.81~8.19)万人次/月,较实施前有显著增长(P<0.001),普通门诊量为7.95(7.55~8.53)万人次/月(P=0.377)、急诊量2.17(1.97~2.84)万人次/月(P=0.143),均较实施前有所下降,但降幅无统计学意义。门急诊构成发生改变,专科门诊构成比提高,普通门诊及急诊构成比下降(P<0.001)。结论新医保政策对广州南部某区属三级甲等综合医院门诊量增长及构成产生影响,专科门诊进一步发展。

Objective To investigate the effect of the new medical insurance policy on outpatient and emergency departments in a Three A and Tertiary Hospital in south Guangzhou. Methods Clinic data before and after the new insurance policy implementation during 2013 to 2016 was collected and analyzed. Using rank sum test and chi square test to find the differences of the quantity, rate of increase and constituent ratio. Results The outpatient number was 4341.4 thousand, and the growth slow down significantly （0. 06% （-2. 70%- 3.76%） per month, P= 0. 001） after new insurance policy implementation. The number of specialist out-patient （79.4（78. 1-81.9） thousand per month, P〈0. 001） increased greatly, while ordinary out-patient （79. 5 （75.5-85.3） thousand per month, P=-0. 377） and emergency department （21.7 （19.7-28.4） thousand per month,P=0. 143） decreased slightly. The composition of clinic changed, with growth of specialist out-patient and decline of ordinary out-patient and emergency department （P〈0. 001）. Conclusions The new insurance policy had an impact on the growth and composition of the clinic in a Three A and Tertiary Hospital in south Guangzhou, and the specialist clinic should be developed further.