比较北京市医药分开综合改革对某部队医院的影响和启示

Influence of clinic-pharmacy-separation reform on a military hospital

目的探索北京市医改新形势下某部队医院发展的差异,为下一步医院发展提供管理依据。方法分别选取医院医改前后各一个季度的医疗工作量、医疗收入及结构变化数据进行自身同比、环比对照,同时与北京市三级医院整体情况进行比照,在分析医药分开综合改革对医院各项指标数据影响的同时,探索医院发展与北京市三级医院整体发展水平的差异。结果从工作量来看,医改后北京市三级医院门急诊量普遍下降,但某部队医院下降更为明显;出院人次普遍有所增加,但某部队医院减少明显;医疗收入普遍持平略有增长,但某部队医院医疗收入大幅下降。结论医药分开综合改革后,某部队医院门诊量、收入结构变化与北京市三级医院整体情况基本一致,但收容、收入变化差异较大,一方面反映出医改结果符合改革的政策导向,达到了预定的目标;另一方面反映出部队医院发展存在特殊问题,结合当前医改、军改双重考验,提示部队医院发展到了转型重塑期,面临新的挑战。

Objective To compare the collected data on a military hospital with that of other tertiary medical institutions in Beijing after the medical reform in order to provide reference for the future development of related hospitals. Methods The quarterly healthcare workload,earnings and structural changes at a particular hospital after the medical reform in 2017 were compared with the same period of 2016 and also with those from other tertiary hospitals in Beijing. The effect of separation of clinic practice from pharmacy on hospitals was evaluated while the future development of tertiary hospitals in Beijing was discussed. Results After the medical reform,the workload of outpatient and emergency departments of tertiary hospitals in Beijing generally dropped,especially in this military hospital. The number of discharged patients generally increased,but decreased significantly in this hospital. Healthcare earnings generally increased,but dropped significantly in this hospital. Conclusions After the comprehensive reform of healthcare,the number of outpatients and income structure of this military hospital are changing in basically the same way as in other tertiary hospitals in Beijing.However,there is considerable difference in the amount of hospitalization and earnings. On the one hand,this reflects that the results of the healthcare reform are in line with the guidelines for the reform. On the other hand,it reveals problems existing in the development of military hospitals. It is worthy of note that military hospitals have entered a stage of restructuring and transformation and are faced with new challenges.