医药分开综合改革对医院门诊收入结构的影响分析

The Analysis of the Impact of Comprehensive Reform of the Separation Between Medical and Pharmaceutical Services on the Income Structure of Outpatients in Hospital

目的了解医药分开综合改革对某区属三级医院门诊收入结构的影响。方法采用对比分析法,调取某医院HIS系统(医院信息系统,Hospital Information System)中综合改革前(2016年5月—12月)和改革后(2017年5月—12月)相关数据进行分析,采用两个独立样本t检验统计学方法进行对比分析。结果2017年5—12月对比2016年同期,门急诊诊疗人次降幅11%,门急诊总收入降幅9%,次均费用均值增加10.8元,P>0.05;次均药费均值减少18.4元,P<0.05;大型设备次均检查费均值减少2.1元,P<0.01;次均手术治疗费均值增加8.5元,P<0.01。结论样本医院的门急诊收入结构变化基本符合新医改收入结构调整目标,控制不合理医药费用增长取得初步成效。

Objective To explore the impact of comprehensive reform of the separation between medical and pharmaceutical services(SBMPS)on the income structure of outpatient clinics in a districtlevel hospital.Methods Data were collected form the HIS system before the comprehensive reform(May-December 2016)and after the reform(May-December 2017),including the number of patient from emergency department and outpatient,the average cost,the average medicine cost,the average large equipment examination fee(CT scan and nuclear magnetic imaging(MRI)),the average surgical treatment fee,the income structure of outpatient and emergency department,and other data.Comparative analysis was performed using two independent sample t-test.Results Compared with May to December 2016,from May to December 2017,the patient number of outpatient and emergency department decreased by 11%.The total income of outpatient and emergency department decreased by 9%.The average cost per time increased by 10.8 Yuan(P>0.05);the average medicine fee decreased by 18.4 Yuan(P<0.05);the number of patients with large equipment(CT,MRI)examinations increased by 14.6% while the average examination cost per time decreased by 2.1 Yuan(P<0.01);the average surgical treatment cost per time increased by 8.5 Yuan,(P<0.01).Conclusion The change of income structure of the outpatient and emergency department of the sample hospital is basically in line with the income adjustment target of the comprehensive reform.The goal of controlling the unreasonable medical expenses has been somewhat achieved.