医共体居民医保打包付费对牵头医院收入结构影响研究

Study on the Impact of Medical Insurance Package Payment on the Income Structure of Leading Hospitals in the Medical Community

目的在祥云县实施医共体医保打包付费改革背景下,研究县域医共体居民医保打包付费改革对牵头医院收入结构的影响。方法采用文献分析法、比较分析法、政策研究法、案例研究法、深度访谈法相结合的研究方法,研究了牵头医院打包付费改革前后收入结构的变化情况,从而发现医保打包付费对医院收入结构的影响程度。结果通过牵头医院2015年至2020年收入结构的变动值、变动度、变动贡献率的研究,结果发现医院收入结构得到不断优化,药品收入占比持续下降,医疗服务性收入占比持续提高,门诊收入占比提高,住院收入占比下降。结论打包付费对医院收入结构有正向影响,促进医院优化收入结构,提升服务能力,形成良好分级诊疗局面。

Objective:To study the impact of package payment reform on the income structure of the leading hospitals in Xiangyun County under the background of the implementation of package payment reform.Method:Five research methods,including literature analysis,comparative analysis,policy research,case study and in-depth interview,were adopted to study the changes in the income structure of leading hospitals before and after the package payment reform.And the impact degree of medical insurance package payment on hospital income structure was discovered.Result:Through the study of the changes in revenue structure,degree of change,and contribution rate of the leading hospitals from 2015 to 2020,it was found that the hospital's revenue structure has been continuously optimized,with a continuous decrease in the proportion of drug revenue,a continuous increase in the proportion of medical service revenue,an increase in the proportion of outpatient revenue,and a decrease in the proportion of inpatient revenue.Conclusion:Package payment has a positive impact on the hospital's income structure in promoting the optimization of the hospital's income structure,enhancing service capabilities,and forming a good situation of hierarchical diagnosis and treatment.