北京市医药分开和医耗联动改革对某院的影响分析

Analysis on the Effect of the Medicine Separation Reform and Medical Consumables Reform on a Hospital in Beijing

目的分析北京市实施医药分开综合改革和医耗联动改革前后医院的主要医疗指标及收入结构变化情况和影响。方法选择2016年-2019年每年7月-12月的数据,采用同期对照的方法,对两次医改前后主要医疗指标情况、收入构成情况进行描述性分析,采用t检验分别对医药改革前后、医耗改革前后及两次医改前后数据进行差异对比。结果医耗改革后与医药改革前相比门急诊人次下降18.17%,出院人次下降12.99%,医疗收入下降9.56%,住院次均费用下降3.5%,门急诊次均费用增长28.17%,差异均具有统计学意义。结论通过医药分开改革和医耗联动改革,实现了医疗机构的分级诊疗,持续优化了医疗机构收入结构,提高了医务人员积极性,促使医院逐步由资源消耗规模扩张型向内涵质量效率型发展方向转变。

Objective To analyze the changes and effect of main medical indexes and income structure of a hospital in Beijing.Methods Select July-December data for each year 2016-2019,descriptive analysis of the main medical indicators and income composition before and after the two medical reform and analyze the comparison of differences by t-test.Results After the reform,the number of outpatient and emergency visits decreased by 18.17%,the number of discharge visits decreased by 12.99%,the medical income decreased by 9.56%,the average cost of inpatient visits decreased by 3.5%,and the average cost of outpatient and emergency visits increased by 28.17%,the differences were statistically significant.Conclusions Through the medicine separation reform and medical consumables reform,it realized the hierarchical diagnosis and treatment of medical institutions,the revenue structure of medical institutions has been continuously optimized,and increased motivation of medical staff,promote the hospital gradually from the expansion of the scale of resource consumption to the connotation of quality and efficiency-oriented development.