某三级甲等综合医院控制神经内科门诊均次费用的实践探讨

Controlling the average cost per visit for neurology outpatients in a tertiary general hospital

目的综合评价某三级甲等综合医院神经内科门诊均次费用管控的实践过程和管理效果,为提升门诊服务和优化三级公立医院绩效考核指标提供参考和借鉴。方法回顾性分析某三级甲等综合医院2020年神经内科门诊患者诊疗费用数据,并对费用增长的原因进行分析,其主要原因包括:管理部门职责不清、缺乏科学有效的考核制度、人工审方能力有限、患者的不合理要求及受到新冠肺炎疫情防控的影响。针对上述原因实施了相应的改进措施,包括:建立管理小组、完善考核机制、利用信息化手段、加强健康宣教等。结果通过管控,2021年1月—6月,与前1年同期相比,神经内科门诊均次费用、门诊药品费用、药占比均有大幅下降。讨论建立管理小组,完善考核机制,利用信息化手段,加强健康宣教等措施的实施有利于神经内科门诊均次费用的有效控制。

Objective To evaluate the effects in controlling the average cost per visit(ACPV)for neurology outpatients in a tertiary general hospital,with an attempt to improve outpatient services and optimize performance assessment indexes in tertiary public hospitals.Methods We retrospectively analyzed the patient consultation cost data in the neurology outpatient department in a tertiary general hospital in 2020,especially the causes of cost growth,which mainly included unclear management responsibilities,lack of a scientific and effective assessment system,limited capacity of manual prescription review,unreasonable request by the patients,and impact of COVID-19 prevention and control measures.Relevant solutions were then implemented,including establishing a management team,improving the assessment mechanism,adopting information technology,and strengthening patient education.Results After the adoption of these control measures,the ACPV,outpatient drug cost,and proportion of prescription drug costs decreased significantly compared to the same period last year.Conclusions ACPV in neurology outpatients can be effectively controlled by establishing a management team,the assessment mechanism,adopting information technology,and strengthening health education.