三明市公立医院运行新机制的效果评价

Evaluation of the effectiveness of the new operation mechanism of public hospitals in Sanming

目的对三明市公立医院运行新机制进行跟踪评价并总结经验,为公立医院运行新机制的持续发展提供理论依据。方法选取2011—2021年三明市和全国公立医院的医疗收入和患者负担费用数据,采用结构变动法分析并比较三明市和全国公立医院的医疗收入结构变动情况,对患者负担费用进行描述性分析,以验证三明市公立医院运行新机制的效果。结果2012—2021年,三明市公立医院医疗服务收入和药品耗材收入的累计结构变动值分别为29.58%和-32.29%,优于全国的-0.95%和-0.68%;三明市公立医院医疗服务收入和药品耗材收入的结构变动贡献率年均为78.10%,高于全国的49.43%。2011—2021年,三明市公立医院患者次均门急诊费用的平均增幅为4.35%,低于全国的5.97%;次均住院费用平均增幅为3.91%,低于全国的5.40%。结论三明市公立医院运行新机制效果显著,在一定政策条件下是可持续的。

Objective To evaluate the effectiveness of the new operation mechanism of public hospitals in Sanming,so as to provide a theoretical basis for the sustainable development of the new operation mechanism for public hospitals.Methods The data on medical income and patient costs of public hospitals in Sanming and the whole country from 2011 to 2021 were selected,structural variation analysis was used to analyze and compare the changes in the structure of medical income of public hospitals in Sanming City and the whole country,and descriptive analysis was carried out on the patient burden costs,in order to validate the effect of the new operation mechanism for public hospitals in Sanming.Results From 2012 to 2021,the cumulative values of structure variation in medical service revenue and drug/consumable revenue of public hospitals in Sanming City were 29.58% and -32.29% respectively,better than the national figures of -0.95% and -0.68%;the annual contribution rate of structural variation in the medical service revenue and drug/consumable revenue of public hospitals in Sanming were 78.10% on average,higher than the national figure of 49.43%.From 2011 to 2021,the average increase in the average outpatient and emergency care costs per patient in public hospitals in Sanming was 4.35%,lower than the national average of 5.97%;the average increase in the average inpatient costs per patient was 3.91%,lower than the national average of 5.40%.Conclusions The new mechanism for the operation of public hospitals in Sanming is effective and sustainable under certain policy conditions.