广州某三甲医院医改政策对临床指标影响的初步研究

A pilot study of the impact of health care reform policies on clinical indicators

目的研究医改政策(按病种分值付费、药品及耗材零加成、药品及耗材集中带量采购)对临床指标的影响。方法回顾性观察研究,从广州市某三甲医院病案系统获取2015年1月1日—2021年12月31日住院患者数、性别、年龄、在院死亡率、住院总费用、自费金额、住院天数、医保类型、疾病主诊断等临床指标,分析不同医改政策实施前后对临床指标的影响。结果研究期间共597884人次住院。医改政策对年龄、住院总费用、自费金额、平均住院天数、医保类型有影响,对性别,在院死亡率无影响。结论医改政策的实施使部分临床指标发生了明显变化。

Objective To study the influence of health care reform policies(Zero-markup policy of drugs and consumables,Diagnosis-intervention packet,Procurement with target quantity of drugs and consumables)on clinical indicators.Methods A retrospective observational study was carried out,from one hospital medical record system in Guangzhou on January 1,2015 to December 31,2021.Clinical indexes,such as hospitalized patients with number,gender,age,in-hospital mortality,total hospitalization cost,out-of-pocket amount of cost,average hospitalization days,types of health care insurance,and the main diagnosis,were analyzed to study the different influences on clinical indicators before and after the reform of policies.Results Health care reform policies had influences on age,total hospitalization cost,out-of-pocket amount of cost,average length of stay and types of health care insurance,but not on gender and in-hospital mortality.Conclusion The implementation of health care reform policies changed some clinical indexes obviously.