新医改形势下某三甲医院全科医学科临床绩效分析

Clinical Performance Analysis of General Medical Department in a Top Three Hospital under the Situation of New Medical Reform

目的对新医改形势下某三甲综合医院全科医学科临床收治患者的医疗指标进行总结,旨在为三甲医院全科科室管理考核提供参考依据。方法选择我院2016年1月1日~2018年12月31日出院患者数据,采用对比和叙述性统计的方法,分析该院全科医学科在新医改形势下住院人次、疾病构成、平均住院日、次均住院费用、费用构成和药占比等指标的变化。结果2016年我院全科收治患者246例,2017年增加至288例,2018年收治349例,同比上涨41.87%;平均住院天数由2016年的15.85 d降低到2018年的12.66 d,次均住院费用逐年降低;2016~2018年我院全科医学科收治患者病种占比较大的分别是脑梗死及后遗症、肺部感染、脑血管供血不足、脑出血后遗症、2型糖尿病、冠状动脉粥样硬化性心脏病、高血压、帕金森氏病、慢性阻塞性肺疾病;患者住院费用主要包括药品费用、材料费用、检查费用、手术费用、护理治疗费5个方面,其中检查费用、药品费用最高,2016~2018年检查费用占比分别为16.34%、18.52%和23.92%,药品费用占比分别为54.47%、47.65%和42.01%。在控制住院总费用的前提下,材料费用、检查费用、手术费用占比逐年上升。结论在新医改形势下,我院全科医学科收治病员量逐年上升,病种涉及多个专科,平均住院日、次均住院费用、药品费用占比逐年下降,减轻了患者的经济负担,与国家层面公立医院改革要求不谋而合。

Objective To summarize the medical indicators of clinically admitted patients in the general medical department of a top three general hospital under the new medical reform situation,in order to provide a reference for the management assessment of general departments in the top three hospitals.Methods The data of patients in our hospital from January 1,2016 to December 31,2018 were collected,and the number of hospitalizations,disease composition,and average hospitalization in the general medical department of the hospital under the new medical reform situation were analyzed using comparative and descriptive statistics.Changes in daily and average hospitalization expenses,cost composition,and medicine ratio.Results In 2016,246 patients were treated in our general department,which increased to 288 in 2017.In 2018,349 patients were treated,a year-on-year increase of 41.87%;the average length of hospital stay decreased from 15.85 d in 2016 to 12.66 d in 2018.Decreasing year by year;from 2016 to 2018,the relatively large proportion of patients admitted to our hospital's general medical department are cerebral infarction and sequelae,pulmonary infections,insufficient cerebral blood supply,sequelae of cerebral hemorrhage,type 2 diabetes,and coronary atherosclerosis Sexual heart disease,hypertension,Parkinson's disease,and chronic obstructive pulmonary disease;the patient's hospitalization costs mainly include five aspects:drug costs,material costs,examination costs,surgery costs,and nursing treatment costs,of which the inspection costs and drug costs are the highest.From 2016 to 2018,the inspection costs accounted for 16.34%,18.52%,and 23.92%,and the drug costs accounted for 54.47%,47.65%,and 42.01%,respectively.Under the premise of controlling the total cost of hospitalization,the proportion of material costs,examination costs,and surgical costs has increased year by year.Conclusion Under the new medical reform situation,the number of patients admitted to the general medical department of our hospital has increased year by year.The disease involves multiple specialties.The average hospitalization day,average hospitalization cost,and drug cost ratio have decreased year by year,which has reduced the financial burden on patients.The requirements for public hospital reform at the national level coincide.