基于效率与可及性视角的北京市医药分开综合改革效果评价

Evaluation on Effect of Comprehensive Reform of Separating Drug Sales from Medical Services in Beijing:Based on Perspective of Efficiency and Accessibility

目的基于效率与可及性视角,评价北京市医药分开综合改革实施效果。方法运用描述性分析结合间断时间序列分析(Interrupted Time Series Analysis, ITSA)方法对各项评价指标进行分析。结果北京市医药分开综合改革实施以来,分级诊疗建设成效显著;二、三级医院收入总量稳中有增,结构优化,基层医疗卫生机构收入显著增加;门急诊次均费用与出院例均费用均有所上升;平均住院日降幅较大;慢性病长处方极大提高群众取药的便利性,基层医疗卫生机构医疗服务可及性提高。结论北京市医药分开综合改革多项举措共同发力,使得医疗卫生机构运行效率和患者医疗服务利用可及性有明显提升,促进医疗机构的发展模式由资源消耗规模扩张型向内涵质量效率集约型的转变。

Objective Based on the perspective of efficiency and accessibility,to evaluate the implementation effect of comprehensive reform of Separating Drug Sales from Medical Services in Beijing.Methods Using descriptive analysis combined with the Interrupted Time Series Analysis(ITSA)to analyze evaluation indicators,and evaluating the implementation effect of the reform.Results Since the implementation of the Comprehensive Reform of Separating Drug Sales from Medical Services in Beijing,the construction of hierarchical diagnosis and treatment has achieved remarkable results;the total income of secondary and tertiary hospitals has increased steadily and the structure has been optimized,and the income of primary medical institutions has increased significantly;both the average cost of outpatient and emergency visits and inpatient visits increased;the average hospitalization day has dropped significantly;long-term prescriptions for chronic illnesses have made easier for people to get medicine,and the accessibility to medical services at primary medical and health institutions was improved.Conclusion The joint efforts of a number of measures have significantly improved the operating efficiency of medical and health institutions and the accessibility of patients to use medical services,and promoted the development model change of medical institutions from the expansion of resource consumption to the intensive quality and efficiency.