北京市医药分开综合改革对三级医院患者就医费用影响分析

Analysis on the influence of Beijing medicine reform on the medical expenses of patients in tertiary hospitals

目的分析2017年4月医药分开综合改革对北京市三级医院患者就医费用的影响,为医疗费用管理和医疗服务价格改革提供建议。方法运用描述性分析方法对北京市三级医院2014~2018年的医疗费用数据进行分析,比较医药分开综合改革前(2014~2016年)、改革当年(2017年)和改革后(2018年)患者费用情况。结果医药分开综合改革后三级医院门诊、住院次均费用增幅分别为2.65%、2.44%。门诊、住院药占比分别下降至55.67%、26.54%,住院材料费占比下降至32.43%。住院费用医保支付比例为72.54%。结论医药分开综合改革后三级医院医疗费用水平增幅可控,医疗费用结构有所优化,患者就医负担稳中有降。建议继续深化医疗价格改革,规范和调整医疗服务类收费,加强医疗费用增长管控,以更好实现医院补偿机制转换。

Objective To analyze the impact of the medical separation reform in April 2017 on the medical expenses of patients in grade tertiary hospitals in Beijing, and to provide advice on medical cost management and medical service pricing reform. Methods Descriptive analysis method was used to analyze the medical cost data of Beijing grade tertiary hospitals from 2014 to 2018, and Patients′ costs before the reform(2014-2016), during the reform(2017) and after the reform(2018) were compared. Results After the reform of separating medicine from medicine, the average cost of outpatient service and hospitalization in tertiary hospitals increased by 2.65% and 2.44% respectively, and the proportion of outpatient and inpatient drugs decreased to 55.67% and 26.54% respectively, and the proportion of inpatient materials expenses decreased to 32.43%. The proportion of hospitalization expenses covered by medical insurance was72.54%. Conclusion After the reform of separating medicine from medicine, the level of medical expenses in tertiary hospitals has been increased in a controllable way, the medical cost structure has been optimized, and the medical burden on patients has been steadily reduced. It is suggested that we should continue to deepen the reform of medical price, standardize and adjust the medical service fees, and strengthen the control of the growth of medical expenses, so as to better realize the transformation of hospital compensation mechanism.