C市城市公立医院医药价格改革效果研究

Study on the Effect of Medical Price Reform of Urban Public Hospitals in C City

目的评估C市城市公立医院医药价格改革实施效果以及对医院经济运行的影响,为进一步深化和完善医药价格综合改革提供政策建议。方法收集5家样本医院医药价格改革前后运营指标,进行纵向对比与横向对比,分析医药价格改革对公立医院运行的影响。结果 2016年四季度大部分样本医院业务量、医疗收入及医疗业务支出同比均有增长,且医疗业务支出同比增幅普遍高于医疗收入增幅;所有样本医院药占比均明显下降,诊查、治疗、手术、护理等医务性收入占比则明显提高;大部分样本医院次均费用2016年四季度同比增幅要小于年度同比增幅。结论医药价格改革后,样本医院运行较平稳,医疗收入结构趋于优化,医疗费用增长有所控制,医药价格改革取得了初步成效;但医疗服务价格调整及财政补助未能有效弥补减少的合理收入,需增加政府财政投入,建立科学合理的定价机制,实行三医联动,确保医院健康可持续发展。

Objective Evaluate the effect of medical price reform of urban public hospitals in C city and its impact on the hospitals＇ economic operation,so as to provide policy recommendations for further deepening and improving comprehensive reform of medical prices. Methods Compared main operating indices of five sample hospitals before and after the medical prices reform,and then analyzed the effects of medical price reform on the operation of public hospitals. Results In the fourth quarter of 2016,most sample hospitals＇ medical service volume,income and expenditure increased over the same period of 2015,and the growth rate of medical service expenditure was higher than that of medical service income. The proportion of medicine income decreased significantly in all sample hospitals,and the proportion of surgery,nursing and other medical service income significantly increased. For most sample hospitals,the growth rate of medical expenditure per patient in 2016 fourth quarter was lower than that in the whole year. Conclusion After medical price reform,most sample hospitals run normally,medical income structure tends to be optimized,the growth rate of medical expenses has been controlled. Medical price reform has achieved initial effect. But medical service price adjustment and the financial subsidy cannot effectively make up for the loss of reasonable income of sample hospitals. More government financial investment,establishment of the scientific and rational pricing mechanism,implementation of tripartite system reform are requisite to ensure the healthy and sustainable development of public hospitals.