医耗联动综合改革对某院儿童住院费用的影响

The Influence of the Comprehensive Reform of Medical Consumption on Children’s Hospitalization Expenses

目的 观察医耗联动综合改革对北京某三甲儿童专科医院住院费用的影响,观察改革效果,提供改革后实证性数据参考。方法 选取出院时间2018年1月1日至2020年12月31日某院67618人次医保患者住院病案首页及结算数据,以2019年6月整月作为改革分界点,对按月次均住院费用,各项分类费用占比进行时间序列分析。结果 改革实施引发了住院费用结构改变,改革后当月次均手术麻醉费及治疗费分别增加307.7元(2.41%)和138.5元,耗材费瞬时下降291.7元(-2.79%),其中治疗耗材下降149.7元,手术耗材下降160.6元,且手术麻醉费改革后存在增长趋势(33.1元/月)。结论 改革后手术麻醉治疗费用占比增加,耗材占比下降,实现结构调整效果。

Objectives To observe the impact of the comprehensive reform of medical consumables on the hospitalization expenses of a children’s hospital in Beijing. Methods To select the data of medical records and cost of medical insurance patients in this hospital from January1st, 2018 to December 31st, 2020, and conduct an interrupted time series of the monthly average hospitalization expenses and the proportion of each category of expenses. Results The reform implementation caused a significant change in the structure of hospitalization expenses. Treatment expenses and surgical anesthesia expenses had increased 307.7(2.41%) and 138.5, and consumables decreased 291.7(-2.79%). And surgical consumables have a trend of faster growth after the reform(33.1 Yuan/month). Conclusions After the reform, the proportion of surgical anesthesia treatment costs had increased, and the proportion of consumables had decreased, realizing the effect of structural adjustment.