湖南省基层卫生医疗机构经济运行现状及发展对策研究

Status quo of the economic operation of primary health institutions in Hunan Province and the development strategies

目的了解2014—2018年湖南省基层卫生医疗机构经济运行情况,促进湖南省基层卫生医疗机构持续健康发展。方法从2014—2018年湖南省卫生健康事业发展统计公报、卫生财务年报中提取基层卫生医疗机构的相关数据资料,采用定性与定量相结合的方法进行分析。结果2018年与2014年比,湖南省基层卫生医疗机构数、诊疗人次所占总诊疗人次比重和病床使用率分别下降了6.69%、2.56%和2.29%。收支结余缺口从2014年2.62亿元扩大为2018年8.40亿元。药品收入占比从2014年26.18%降为2018年22.61%。在医疗支出和公共卫生支出中,城市社区支出比乡镇卫生院支出增速分别快7.81%和4.59%。结论湖南省基层卫生医疗机构应合理控制药占比,加强紧密型医联体建设,发挥中医药特色优势,提升医疗服务能力,财政应加快推进基层卫生医疗机构的长效财政补偿机制。

Objective To know about the economic operation status of primary health institutions in Hunan Province from 2014 to 2018 in order to promote their sustainable and healthy development.Methods Relevant data were collected from health statistics yearbook and health financial annual report of Hunan health service development from 2014 to 2018,and analysis was made using quantitative and qualitative methods.Results Compared with 2014,in 2018 the number of primary health institutions,the proportion of diagnosis and treatment person times and the utilization rate of hospital beds in Hunan decreased by 6.69%,2.56%and 2.29%respectively.The balance of revenue and expenditure expanded from RMB 262 million in 2014 to RMB 840 million in 2018.The proportion of drug revenue decreased from 26.18%in 2014 to 22.61%in 2018.As for medical expenditure and public health expenditure,the growth rate of urban community expenditure was 7.81%and 4.59%faster than that of township health centers respectively.Conclusions Primary health institutions in Hunan Province should make rational control of the proportion of drugs,strengthen the construction of close medical association,give full play to the characteristic advantages of traditional Chinese medicine,and improve the medical service capacity.Finance department should accelerate the long-term financial compensation mechanism for primary health institutions.