药品零差率政策对市级公立医院门诊费用的影响

Influence of Zero Drug Rate Policy on Outpatient Costs of Municipal Public Hospitals

目的探讨药品零差率政策对各级别公历医院门诊收入的影响,并为优化门诊费用结构、减轻患者疾病负担提出针对性建议。方法收集2014—2020年西部某市级公立医院门诊费用数据并运用灰色关联度分析与结构变动分析相结合的方法对其进行统计分析。结果2014—2020年二级医院的结构变动度(DSV)大于三级医院,分别是22.04%、20.61%,就总体情况而言,药品收入、检查收入的结构贡献率明显大于其他项目,分别为42.48%、16.53%,两者累计贡献率为59.00%。结论样本市级公立医院门诊费用中药品收入占比呈下降趋势,二级医院实施效果尤为显著,但体现医务人员价值的项目占比不高。因此政府应加大财政投入,医院加强管理,从而有效提升医院核心能力,减轻患者疾病负担。

Objective To explore the impact of the zero difference policy on outpatient revenue of hospitals at all levels,and provide targeted suggestions for optimizing outpatient cost structure and reducing patients'disease burden.Methods This paper collects data on outpatient costs of public hospitals in western China from 2014 to 2020 and uses a combination of gray correlation analysis and structural change analysis to conduct a more detailed statistical analysis of them.Results From 2014 to 2020,the structural change degree of secondary hospitals was greater than that of tertiary hospitals,which were 22.04%and 20.61%respectively.In terms of the overall situation,the structural contribution rate of drug income and inspection income was far greater than that of other projects,which were 42.48%and 16.53%respectively,and the cumulative contribution rate of the two was 59.00%.Conclusion The proportion of outpatient expenses of Traditional Chinese medicine in the sample municipal public hospitals shows a downward trend,and the implementation effect of secondary hospitals is particularly significant,but the proportion of items reflecting the value of medical staff is not high.Therefore,the government should increase financial input and strengthen hospital management,so as to effectively improve the core capacity of hospitals and reduce the disease burden of patients.