北京两项改革措施的实施对医疗机构门急诊患者就医流向影响的研究

Study on the Influence of Medical Reform Policy on the Flow of Outpatient and Emergency Patients in Beijing Medical Institutions

目的了解北京市经过医药分开及医耗联动改革对门急诊患者就医流向的影响.方法选取北京市卫生综合统计信息平台2016年1月—2019年12月各级医疗机构门急诊就诊人次的相关数据,采用描述性分析和间断时间序列的分析方法,对改革带给门急诊人次的影响进行分析.结果医药分开及医耗联动改革实施以来,三级医院门急诊服务量较医药分开改革前下降5.43%,较医耗联动改革前上升3.81%.基层机构较医药分开改革前上升39.91%,较医耗联动改革前上升7.70%.结论两项改革措施对于三级医院门急诊量起到一定分流作用,基层机构门急诊增幅明显上升,分级诊疗效果显现.

Objective To understand the in fluence of two reforms of medical separation and medical consumption linkage on the flow of outpatient and emergency patients in Beijing.Methods The data of outpatient and emergency visits of medical institutions at all levels from January 2016 to December 2019 were selected from the Beijing health comprehensive statistical information platform,and the impact of the reform on outpatient and emergency visits was analyzed by descriptive analysis and interval time series analysis.Results Since the implementation of the two reforms,the number of outpatient and emergency services in tertiary hospitals has decreased by 5.43%compared with that before the reform of medical separation,and increased by 3.81%compared with that before the reform of medical consumption linkage.The number of visits in grass-roots institutions increased by 39.91%and 7.70%compared with that before the reform.Conclusion The two reforms play a significant role in diverting the number of outpatient and emergency treatment in tertiary hospitals.The growth rate of grass-roots institutions has increased significantly,and the effect of hierarchical diagnosis and treatment is obvious.