中医医疗服务项目价格政策效果评估与建议

Evaluation and suggestions on the effect of price policy of TCM medical service items

[目的]通过评估中医医疗服务项目价格政策效果,探讨促进中医医疗服务项目发展及价格完善的政策建议。[方法]对抽取的成都市70家医疗卫生机构2019年的财务数据和中医类医疗服务项目收费情况进行描述分析及价格水平差异指数分析;并通过现场调研的方法,了解5家中医医院中医医疗服务项目收费情况。[结果]样本公立医院实际执行中医医疗服务项目114项(占79.72%),样本基层机构实际执行67项(占46.85%);中医类服务项目收入仅占医院服务类总收入的5.99%;使用量前10位的中医类服务项目频次达1469万次,占全部项目频次的68%,其收入占比达54%。[结论]中医医疗服务收费项目数量少,收费水平普遍偏低;中医医疗服务市场规模有限,中医医疗服务能力欠佳;中医类服务项目发展不均衡,高频低价经济贡献显著;中医医疗服务发展受医疗服务收费与支付政策限制。建议:借助医保支付方式改革助推中医医疗服务快速发展;完善中医类服务项目定价依据,建立健全成本测算体系;深化中医医疗服务价格改革,建立合理的动态调整机制;依靠信息化技术建立中医医疗服务定价决策支持体系。

Objective Discuss policy suggestions for promoting the development of TCM medical service items and price improvement of TCM through evaluating the effect of price policy of TCM medical service items.Methods The financial data of 70 medical institutions of Chengdu in 2019 and the charges of TCM medical service items were conducted descriptive analysis and price level differentiation index analysis;Knew the charges of TCM medical service items in 5 TCM hospital.Results The sample public hospitals actually implemented 114 items(79.72%),and the sample primary medical institutions actually implemented 67 items(46.85%);The income of TCM services only accounted for 5.99% of the total income;The frequency of the top 10 TCM service items was 14.69 million times,accounted for 68% of the total frequency,and its income accounted for 54%.Conclusions The number of charging items of TCM medical services was few,and the charging level was generally low;The scale of TCM medical service market is limited,and the ability of TCM medical service is not good;The development of traditional Chinese medicine service projects is uneven,and the high-frequency and low-price economy makes a significant contribution;The development of TCM medical service is limited by the policy of medical service charge and payment.It is suggested that promote the rapid development of TCM medical services through the reform of medical insurance payment mode,improve the pricing basis of TCM service items and and establish cost measurement system,deepen the price reform of traditional Chinese medicine medical services and establish reasonable dynamic adjustment mechanism,and establish decision support system for the pricing of traditional Chinese medicine medical services by relying on information technology.