我国三级医院患者医药费用构成分析

The structural analysis on patient’s medical expenses in Grade Ⅲ hospitals

目的:对国内三级医院患者门诊和住院医药费用构成情况进行分析,为宏观政策制定和三级医院治理提供决策依据。方法:利用结构变动度、结构变动值、结构变动贡献率以及拉动力等指标综合分析2012-2018年三级医院患者次均门诊和住院医药费用构成变动趋势。结果:三级医院患者次均门诊和住院医药费用中药费比例不断降低,费用中医疗费、护理费等比例不断增加;医药费用中药费占比较大,卫生材料费增长趋势需要引起重视。结论:医改以来三级医院患者次均医药费用构成不断优化,在控制住院费用过快增长方面取得一定效果,但还需持续控制和引导。此外,还需加大力度完善医保制度,提升医疗服务可及性。

Objective:To analyze the structural change of patient’s medical expenses in Grade Ⅲ hospitals for giving references to government decision-making and residents’information getting.Methods:Methods including VSV,DSV,Contribution rate and Driving force were used on the analysis of trends and changes of patient’s inpatient and outpatient medical expenses in tertiary hospital from 2012 to 2018.Results:The composition of expenses for medicine of patient’s medical expenses in Grade Ⅲ hospitals decreased continually and the proportion of operation and nursing expenses increased.Medical expenses still account for the largest proportion and attention should be paid on increasing of medical materials.Conclusions:The structure of patient’s medical expenses in Grade Ⅲ hospitals improved a lot.There are effects on controlling the increase of inpatient expenses.The more efforts should be spared on controlling and guiding the medicine and materials expenses.In addition,insurance system should be improved to guarantee the ability to afford the disease burden.