2013-2019年我国公立医院医疗费用控制效果分析

Analysis on the effect of controlling medical expenses in public hospitals from 2013 to 2019

[目的]分析评价《关于控制公立医院医疗费用不合理增长的若干意见》实施前后我国公立医院控制医疗费用不合理增长情况。[方法]抽取2014-2017年《中国卫生和计划生育统计年鉴》、2018-2020年《中国卫生健康统计年鉴》中的相关数据指标,对“公立医院医疗费用控制主要监测指标”进行动态分析。[结果]2013-2017年我国公立医院门诊病人次均医药费用、住院病人人均医药费用增速减缓,2018-2019年有所回升;2013-2019年我国公立医院门急诊收入占医疗收入的比例总体呈下降趋势,由34.63%下降到33.97%;住院收入占医疗收入的比例由65.37%上升至66.03%;药占比由2013年的43.31%下降至2019年的32.26%,检查收入和卫生材料占比有所上升;平均住院日由2013年的10.0 d减少至2019年的9.1 d;管理费用率减少4.03个百分点,但资产负债率上升至43.21%。[结论]我国公立医院控费政策取得一定效果,医药费用总体增速减缓,服务效率提高;以药补医机制有所改善,但收入结构仍需进一步优化;公立医院债务负担加重,财务风险增加。

Objective This paper evaluates and analyzes unreasonable growth of medical expenses in public hospitals in China before and after the implementation of the policy of“Some Suggestions About Controlling Unreasonable Growth of Medical Expenses in Public Hospital”.Methods It selected relevant data indicators in“China Health and Family Planning Statistical Yearbook(2014-2017)”and“China Health Statistics Yearbook(2018-2020)”to conduct a dynamic analysis of main monitoring indicators for medical expenses control in public hospitals.Results The growth rate of average person-time medical expenses for outpatients and per capita medical expenses for inpatients in public hospitals slowed down from 2013 to 2017,and speed rose again from 2018 to 2019;The proportion of outpatient income accounted for medical income was on a declining curve from 2013 to 2019,which was from 34.63% to 33.97%;At the same time,the proportion of hospitalized revenue accounted for medical income from 65.37% to 66.03%;the proportion of drug revenue decreased from 43.31% in 2013 to 32.26% in 2019,the proportion of inspection income and health materials income increased somewhat;Average length of stay decreased from 10.0 days in 2013 to 9.1 days in 2019.The management fee rate decreased by 4.03 percentage points,but the asset-liability ratio increased to 43.21%.Conclusions The policy of cost-control has achieved some results,the growth rate of medical expenses in public hospitals has slowed down and service efficiency has improved.It has improved that the mechanism of drug profit make up for treatment profit.But,the income structure still needs to be further optimized.The debt burden of public hospitals has increased,and its financial risk increased too.