摘要
In the present study,we aimed to assess the long-term impact of zero-markup drug policy on volume of medical service in county hospitals of China.This study used 57 county hospitals’records of medical service from 2011 to 2015,and a fixed effect model was applied to examine the impact of the zero-markup drug policy on volume of medical service.The outcome indicators included the number of patient visits,the number of prescriptions,the number of discharged patients,the length of stay,the number of patients who had surgeries and the number of patients who had CT or MRI,monthly.The number of hospitals which implemented the zero-markup drug policy was increased continuously.By the end of 2015,41 hospitals(71.9%)implemented this policy.The panel regression showed that most indicators were insignificantly decreased,including the number of patient visits(P<0.01),the length of stay(P<0.05),the number of patients who had surgeries(P<0.01)and the number of patients who had CT or MRI(P<0.01).However,the number of prescriptions and the number of discharged patients were not significantly changed.The implementation of the zero-markup drug policy might affect the reduction of the volume of medical service in county-level hospitals and the reason needs to be clarified in future studies.
本研究旨在评估取消药品加成政策对我国县级公立医院医疗服务量的长期影响。本研究采用57家县级公立医院2011–2015年医疗服务量的数据,以诊疗人次、门急诊处方量、出院患者人数、出院者占用总床日数、手术人次数、CT或MRI检查人次数为指标,通过固定效应面板回归,分析取消加成政策对县级公立医院医疗服务量的影响。实施取消药品加成政策的医院数量不断增加。截至2015年底,41家医院(占样本医院总数的71.9%)实施了这一政策。面板回归显示,诊疗人次(P<0.01)、出院者占用总床日数(P<0.05)、手术人次数(P<0.01)、CT或MRI检查人次数(P<0.01)等各项指标均显著下降。然而,门急诊处方量和出院患者人数并没有显著变化。实施药品零加价政策可能会降低县级医院的医疗服务量。其原因还需要在今后的研究中进一步明确。
