基于倾向得分匹配的县级公立医院改革试点效果评价研究

Effect evaluation of pilot reform of county-level public hospitals based on propensity score matching

目的了解县级公立医院改革的效果,为完善医疗改革政策提供依据。方法采用定量分析的方法,利用多来源数据,分析县级公立医院改革对医院服务提供能力、收入与支出以及次均费用影响。结果开展了改革的县级公立医院资源增加,床位数、医务人员数以及设备数增长幅度明显大于未开展改革的县级公立医院;改革组县级公立医院门诊、住院等服务量明显增加,增幅大于对照组。改革组县级公立医院的次均住院、日均住院费用均略大于对照组。结论县级公立医院改革有效提高了医院的服务能力和效率,但是在费用控制方面仍需进一步加强。

Objective To understand the effect of county-level public hospital reform,and provide evidence for improving the medical reform policy.Methods Quantitative analysis method and multi-source data were used to analyze the impact of county-level public hospital reform on service ability,income,expenses and average cost per visit.Results The resources,the number of beds,medical personnel and equipment of hospitals of the reform group have increased,more than those of the non-reform group.Outpatient and inpatient services in county-level public hospitals increased significantly in the reform group than those in the control group.The average hospitalization and average daily hospitalization expenses of county-level public hospitals in the reform group were slightly higher than those in the control group.Conclusion County-level public hospital reform effectively improved the service capacity and efficiency of the hospital,while the cost control need to be further strengthened.