医药分开综合改革对公立医院经济运行质量的影响:以医疗费用为中介变量

The Influence of Medical Separation Comprehensive on the Quality of Economic Operation in Public Hospitals: Using Medical Expenses as Intermediary Variables

目的:以医疗费用为中介变量,实证研究医药分开综合改革对医院经济运行质量的影响路径。方法:运用回归分析、中介效应检验验证医药分开综合改革与医院经济运行质量的相关关系以及医疗费用的中介作用。结果:药品收入、医院服务收入、财政补助收入分别与医疗费用及医院经济运行质量呈正相关,医疗费用在药品收入与医院总收入间起中介作用,在财政补助收入与医院资产负债率间起中介作用,在财政补助收入与医院总收入间起部分中介作用。结论:医药分开综合改革通过医疗费用间接影响医院总收入。合理调整医疗服务价格,理顺患者医疗费用结构、加大财政补助投入是改变医药分开综合改革对医院总收入影响的关键环节。

Objective： To study the influence route of medical separation comprehensive reform on the quality of hospital economic operation by using medical expenses as an intermediary variable. Methods： Regression analysis and intermediary effect test were used to verify the relationship between the policy of separating medicine, the quality of hospital economic operation and the intermediary role of medical expenditure. Results： The drug income, hospital service income, financial subsidy income were positively correlated with the quality of economic operation and hospital medical expenses. Medical expenses played an intermediary role in the total in- come in the hospital and drug income, while it played an intermediary role between the hospital financial subsidy income and and asset liability ratio. There was certain the mediating effect between financial subsidy income and total income in the hospital. Conclu- sion： Medical separation comprehensive reform indirectly affected the hospital revenue through medical expenses. Reasonable adjust- menting medical service price, straightening out the medical expenditure structure and increasing financial input were the key links to change the comprehensive reform of separating medicine from the total income of the hospital.