新型冠状病毒肺炎疫情对公立医院服务供给的影响--基于北京市F医院的实证研究

The impact of Covid-19 pandemic on medical service supply in public hospitals:Empirical research based on F hospital in Beijing

目的:分析新型冠状病毒肺炎疫情对公立医院医疗服务供给的影响。方法:使用北京市F医院2019年1月至2020年8月的月度住院医疗服务数据,应用间断时间序列回归分析方法,从住院医疗服务数量、服务结构、服务效率、费用水平四个方面分析住院医疗服务供给的变化。结果:疫情防控干预导致F医院住院医疗服务数量大幅降低,手术和重症患者比例增加,费用水平增加,但随着疫情缓解逐步恢复。疫情防控期间,住院医疗服务效率没有明显降低。结论:疫情防控措施全面影响了除服务效率以外的住院医疗服务供给,科学精准防控可以保障基本医疗服务有效供给。建议:通过建立医院应对突发公共卫生事件的工作机制、能力提升机制、监测预警和应急救治机制以及政府财政投入机制,可以更好发挥医院的公共卫生和医疗救治职能。

Objective:This study aimed at analyzing the effect of Covid-19 pandemic on medical service supply in public hospitals.Methods:With monthly data recorded during the period from January 2019 to August 2020 in F hospital in Beijing,this study applied iterated time series(ITS)analysis to investigate the change in inpatient medical service supply in F hospital from four aspects of service quantity,service structure,service efficiency and service cost level.The treatment was considered to begin from February 2020.Results:The pandemic prevention and control intervention led to a significant decrease in quantity of inpatient medical services,whilst the proportion of surgeries and ICU patients and the service cost level experienced a significant increase.As the pandemic got in remission,the medical service supply gradually recovered and came back to normalcy.Meanwhile,the efficiency of inpatient medical services did not significantly decrease during the period of pandemic prevention and control.Conclusion:Pandemic prevention and control measures have affected almost all aspects of inpatient medical services except efficiency.However,scientific and accurate prevention and control can guarantee effective supply of primary medical services.Suggestions:Through setting up the operation mechanism,capacity-enhancement mechanism,monitoring and early warning and emergency treatment mechanism,as well as financial investment mechanism in emergency response,hospitals can best perform their functions of public health and medical service.