基于机构流向法的北京市基层医疗卫生机构中医费用研究

Research on Chinese Medicine Expenditure of the Primary Medical Institutions in Beijing based on the Provider Distribution Method

目的:分析2013—2018年北京市基层医疗卫生机构中医药费用的机构流向及变化趋势。方法:采用个案库汇总法。结果:社区卫生服务机构中医费用占基层中医费用的主体,其增长较快;社区卫生服务机构和诊所对中医服务利用较多;社区卫生服务机构中医费用以中药收入为主,中医科服务量占比少,但发展快;结论:北京市分级诊疗政策效果初显,基层中医药服务发展较快,但仍慢于卫生系统的整体发展,应引导中医优质资源下沉;社区卫生服务机构与诊所中医药服务发展较好,门诊部和村卫生室中医服务发展较慢,应该引导社会资本举办中医门诊部和中医诊所,多手段促进中医类诊所和门诊部发展。社区卫生服务机构的中医药服务以提供中药为主,中医科门诊服务量占比不大,但发展迅速,应提升社区卫生服务机构中医费用的"含金量",体现更多地技术劳务价值。

Objective:To analyze the distribution and trend of Chinese medicine expenditure of primary medical institutions in Beijing from 2013 to 2018.Methods:Case summary method.Results:The expenditure of Chinese medicine in community health service institutions accounts for the majority of the expenditure of Chinese medicine in primary health care institutions,and its growth has been rapid.Community health service institutions and clinics make more use of Chinese medicine services.The expenditure of traditional Chinese medicine in community health service institutions is mainly based on the income of traditional Chinese medicine,and the proportion of traditional Chinese medicine services is small,but it is developing rapidly.Conclusion:The effects of Beijing’s graded diagnosis and treatment policies are beginning to show.The development of Chinese medicine services in primary-level medical and health institutions is relatively fast,but it is still slower in clinics.It needs to guide the flow of high-quality TCM resources to primary-level medical and health institutions;community health service institutions have developed better Chinese medicine services,but outpatient departments and village clinics have slower development.Social capital should be guided to organize Chinese medicine clinics,and multiple means should be used to promote the development of Chinese medicine clinics.The traditional Chinese medicine services of community health service institutions are mainly provided by traditional Chinese medicine.The outpatient service of traditional Chinese medicine accounts for a small proportion,but the development is rapid.The technical labor value of traditional Chinese medicine expenses of community health service institutions should be improved.