医药分开政策对大型国有企业医院运营影响

Effect of Continuous Deepening of Medical Reform on Operation of State-owned Hospitals

目的通过预测、分析、追踪等持续改进的方法与理念探讨医改实施前后对医院运营的影响,并积极采取应对措施、积累宝贵经验,为三级综合医院在新形势下的运营发展提供指导意见。方法样本选取2016年(医改前)和2018年(医改后)数据,运用SPSS17. 0进行配对T检验和Wilcoxon秩和检验,分析变化趋势及对运营的影响因素。结果根据统计结果分析,显示2016年和2018年院本部门急诊量、出院人次、次均费用、门诊和住院医药收入、社区门诊量和医药收入、医院总体医药收入差异具有统计学意义。门诊就诊结构调整体现医改分级诊疗导向性显著;出院患者人次总体增幅显著体现住院工作量上升;药占比和耗占比下降基本实现费用平移;收入结构变化体现提质降本增效成果显著。结论改革后药占比显著下降,收入结构趋向合理化;分级诊疗成效明显,符合改革导向和目的。

Objective To explore the methods and concepts of continuous improvement before and after the implementation of medical reform, and to actively take countermeasures and accumulate valuable experience so as to provide guidance for the operation and development of tertiary general hospitals under the new situation. Methods Samples were selected for 2016(before medical reform) and 2018(after medical reform) data, and SPSS17. 0 was used for pairing T test and Wilcoxon rank and sum test to analyze the changing trends and factors affecting operations. Results According to the statistical results, the differences of the numbers of emergency and discharge patients, average cost, out-patient and inpatient medical income, the numbers of community out-patients and medical income and hospital total medical income in 2016 and 2018 were statistically significant. The adjustment of outpatient treatment structure showed that the medical reform classification presented significant orientation. The overall increase in the number of patients discharged from hospital showed that the workload of hospitalization increased significantly. Lower Medicine costs and consumption costs kept overall costs from rising. The change of income structure reflected significant efficiency gains in improving the quality. Conclusion After the reform, the proportion of medicine costs decrease significantly, and the income structure tends to be rationalized. The efficacy of graded diagnosis and treatment is obvious, which is in line with the reform direction and purpose.