湖南省中医医疗消费及其结构分析——基于SHA2011卫生费用核算体系

Analysis on TCM medical consumption and its structure in Hunan Province——Based on SHA2011 health expenditure accounting system

[目的]分析2017年湖南省中医医疗消费水平及病种、人群、层级结构,为优化医疗卫生资源配置、促进中医卫生事业发展、制定卫生政策提供数据资料和理论建议。[方法]运用国际最新的“卫生费用核算体系2011版(SHA 2011)”,采用整群随机分层抽样法确定样本机构,通过多维度平衡矩阵分析,将医疗消费分摊至不同指标。[结果]2017年湖南省中医医疗消费总量为156.88亿元,占全省医疗消费的11.61%,其中门诊消费40.12亿元,住院消费116.76亿元;年龄分层总体上呈“M”型分布,其中50~54岁、60~70岁占比最高;消费筹资水平较之2016年,家庭卫生支出(OOP)增长60.03%。[结论]2017年湖南省中医医疗消费整体基数较大,费用增速过快。应控制总量,遏制中医院医疗费用过快增长;同时优化费用结构,进一步落实分级诊疗政策;多元化筹资,发挥中医诊疗的优势作用。

Objective Analyze TCM medical consumption level and disease type,population,and hierarchical structure in Hunan Province in 2017 so as to provide data and theoretical suggestions for optimizing the allocation of medical and health resources,promoting the development of traditional Chinese medicine and health care,and formulating health policies.Methods Based on the latest international“Health Expense Accounting System 2011 Edition(SHA 2011)”,cluster random stratified sampling Method was used to determine the sample institutions.Allocated medical consumption to different indicators through multi-dimensional balance matrix analysis.Results In 2017,the total TCM medical consumption in Hunan Province was 15.688 billion yuan,accounted for 11.61%of the province s medical consumption,of which 4.012 billion yuan was spent in outpatients and 11.676 billion yuan was spent in hospitalization.The age stratification showed an M type distribution,of which the highest proportion was among the ages from 50 years old to 54 and 60 to 70.Compared to 2016,the consumption financing level,household health expenditure(OOP)increased by 60.03%.Conclusions In 2017,the overall cardinal number of TCM medical consumption in Hunan Province was relatively large,and the cost growth was too fast.The total amount should be controlled to curb the excessive increase of medical expenses in TCM hospitals.At the same time,the cost structure should be optimized.Implement hierarchical diagnosis and treatment policy further,diversification financing,develop the advantages of TCM diagnosis and treatment.