基于结构变动度的三级公立医院患者次均住院费用分析

Analysis of inpatient medical income in tertiary public hospitals based on structural change degree

目的分析全国三级公立医院次均住院费用的内部构成及变化,为优化次均住院费用结构、控制医疗费用增长提供参考。方法收集中国卫生健康统计年鉴中三级公立医院患者次均住院费用相关资料,运用结构变动度方法分析2014—2019年全国三级公立医院患者次均住院费用结果变动情况。结果2014—2019年三级公立医院患者次均住院费用逐年上升,其中药费占比逐年下降,卫生材料费占比逐年上升。药费、卫生材料费和手术费是三级公立医院次均住院费用结构变动的主要费用项目,3者累计贡献率超过70%。结论三级公立医院患者次均住院费用结构变动较大,药费管理虽有明显改善,但体现医护人员技术价值的手术费、治疗费等未见显著提升。建议进一步规范诊疗体系,加强医用卫生高值耗材管控,合理提升医疗技术服务价格。

Objective To analyze the internal structure and changes of average inpatient cost in national tertiary public hospitals in China,so as to provide reference for optimizing the average hospitalization cost structure and controlling the growth of medical cost.Methods The data were collected of the average cost of inpatients in tertiary public hospitals in China from Health Statistical Yearbook,and the changes of the average cost of inpatients in tertiary public hospitals from 2014 to 2019 were analyzed by using the structural change degree method for statistical analysis.Results From 2014 to 2019,the average inpatient cost of tertiary public hospitals increased year by year,in which the proportion of drug cost decreased year by year,and the proportion of health materials cost increased year by year.Medicine cost,sanitary cost and operation cost were the three main cost items in the structural change of average inpatient cost in tertiary public hospitals,and the cumulative contribution rate of the three items was more than 70%.Conclusion The income structure of inpatients per time in tertiary public hospitals has changed greatly,the management of drug income has been significantly improved,and the technical value and service value of medical staff have not been significantly improved.It is suggested to further strengthen inspection,control the use of health materials,improve the medical service price reform system,and to further enhance the technical value and service value of medical staff.