吉林省县级公立中医医院与综合医院药品收入比例及其构成情况分析

Analysis on the Proportion of Drug Revenue and Its Composition in the County-level Public TCM Hospital and General Hospital of Jilin Province

目的:分析2013-2016年吉林省县级公立中医医院与综合医院的总收入、财政补助收入、药品收入的现状、变化趋势及存在的问题,为相关部门制定相关政策提供数据参考。方法:根据医院的HIS系统收集吉林省9个市(州)的43个县(市)的42家综合医院、38家中医医院共计80家县级公立医院卫生费用数据,运用Excel软件建立数据库并进行汇总和分析。结果:2013-2016年县级综合医院和县级中医医院药品收入中,药品收入占总收入的比例逐年下降,综合医院药品收入主要以住院药品收入为主,门诊和住院药品收入构成主要以西药为主;中医医院的门诊药品收入与住院药品收入占比相近,门诊药品收入构成主要以西药和中成药为主,住院药品收入构成主要以西药为主;综合医院与中医医院财政补助收入逐年增长,且综合医院财政补助收入远高于中医医院财政补助收入。结论:取消药品加成后县级公立医院医疗费用发生了结构性变化;中医医院门诊和住院的用药情况均表现出“西化”现象,建议财政补助及药品收入考核对县级中医医院应有一定的政策倾斜。

Objective:To analyze the total income,financial subsidy income,drug revenue on situation and tendency of development and existing problems in county-level public traditional chinese medicine(TCM)hospitals and general hospitals from 2013 to 2016 in Jinlin,so as to provide data support for related departments to formulate relevant policies.Methods:The health expenditure data of 80 county-level public hospitals in 42 general hospitals and 38 TCM hospitals in 43 counties(cities)in 9 cities(states)of Jilin Province were cdlected from the HIS system,and the database was created and classified by Excel software.Results:From 2013 to 2016,the proportion of drug revenue accounted for total income in county-level general hospitals and TCM hospitals had decreased year by year.The income of county-level general hospitals mainly based on inpatient dug income,and the drug income of outpatient and inpatients mainly based on western medicines.The ratio of outpatient drug income to inpatient drug income was similar in county-level TCM hospitals,and outpatient drug revenue mainly consisted of western drugs and Chinese patent medicines.The income of inpatient drugs mainly based on western medicines.The financial subsidy income of general hospitals and TCM hospitals had increased year by year,but the financial subsidy income of the comprehensive hospital was much higher than that of TCM hospitals.Conclusion:After the elimination of drug addition,the medical expenses structure of county-level public hospitals has undergone structural changes.The use of medicines in outpatient and inpatient of TCM hospitals shows"Westernization".It is suggested that government and related departments should make a major effort to tilt policies on subsidies and drug income assessment for county-level TCM hospitals.