公立医院改革对骨关节炎患者门诊次均费用的影响分析

Analysis on the Influence of the Public Hospital Reform on Average Osteoarthritis Outpatient Expense Per Visiting

目的:探索骨关节炎患者门诊次均费用的变动程度及趋势,研究影响其结构变动的主要因素。方法:采用新灰色关联法分析门诊次均费用与各项费用的关联程度,采用结构变动度法分析门诊次均费用的结构变动情况。结果:中药费、诊查费和治疗费呈正向变动,西药费、检查费、化验费和材料费呈负向变动。检查费的关联程度最大(0.9417),其次是西药费(0.9095)和治疗费(0.8568);检查费的结构贡献率最大(39.23%),其次是治疗费(24.75%)和中药费(20.24%),三者的累计结构贡献率为84.22%。结论:加强对检查费的监管能够减轻骨关节炎患者的就诊负担;诊查费和治疗费的上升体现了对医务人员提供医疗服务的重视程度;取消药品加成政策对于中西药有不同的影响,中药的开药规范管理需要引起重视。

Objective:To explore the degree and trend of structure variation of osteoarthritis patients’outpatient expense.Methods:Grey relevancy analysis and structure variation analysis were adopted to analyze the average outpatient expense per visiting and different costs of items.Results:There were positive changes in Chinese medicine fee,diagnosis fee and treatment fee,while the proportion of Western medicine fee,examination fee,laboratory fee and materials fee decreased.Examination fee had the greatest relevancy(0.9417),followed by western medicine(0.9095)and treatment fee(0.8568).Examination fee contributed mostly to the structure variation of outpatient expense(39.23%),followed by treatment fee(24.75%)and Chinese medicine fee(20.24%).The cumulative contribution rate was 84.22%.Conclusion:It needed to enhance the supervision on examination fee so as to release the burden of patients with osteoarthritis.The concentration degree of providing medical staff the medical services was embodied by the increase of examine costs and treatment cost Cancelling the Zero Addition in Drug Price had different impacts on western medicine and traditional Chinese medicine.The regulation of examination fee and Chinese medicine fee should be further strengthened.