医院报表信息公开对药品费用的影响研究

The impact of disclosure of hospital operational reports on drug expenses

目的 :通过实证分析,研究福建省三明市医院报表信息公开对门诊及住院药费的影响,并探讨其原因。方法 :三明于2013出台政策以控制药费,其效果在2014年趋于平稳,而后三明开始推出医院报表信息公开。研究基于"健康三明"信息平台所公示的25家医院报表数据,构建分段时间序列模型,评估信息公开对药品费用的影响。结果 :医院报表信息公开之前,医院门诊次均药费和住院人均药费呈现上升趋势。报表公开后,短期内门诊与住院次均药费绝对值无显著变化。长期来看,次均药费上涨趋势得到控制,且这种影响在不同医院间各不相同。结论 :医院报表信息公开短期内不会影响医院门急诊次均药费和住院人均药费,但长期来看能控制药费上涨速度。

Objective To estimate the impact of the disclosure of hospital operational reports on drug expenses through empirical evidence. Methods：Through implementation of a series of pharmaceutical policies,the city of Sanming was able to effectively contain the growth of medical expenses in 2013. However,the impact of previous pharmaceutical policies became moderate in 2014,and the city then promoted disclosure of hospital operational reports. Data from hospital operational reports of 25 hospitals on the online Platform of Health Sanming were used. On the basis of literature review,interrupted time series model was employed to explore the impact of monthly disclosure of hospital operational reports. Results ：Before the disclosure of the hospital operational reports,there was a rising trend on outpatient drug expenses per visit and inpatient drug expenses per discharged patient. After the disclosure,though neither of the indicators has significantly changed,the growth rates of both outpatient drug expenses per visit and inpatient drug expenses per capital have slowed down in the long run. However,the extent of such impact varies among different hospitals. Conclusion ：The monthly disclosure of hospital operational reports will not influence clinical expenditure of out-patient and emergency department or cost of per inpatient in the short period,but it has the impact of controlling drug expense growth in the long run.