|
|
|
| Analysis on the influence of Beijing medicine reform on the medical expenses of patients in tertiary hospitals |
| SUN Shuxue1 LIU Haiyan2 XU Jide3 ZHAO Guanhong4 |
1.Hospital Office, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China;
2.Medical Insurance Office, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China;
3.Statistics Office, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China;
4.Medical Insurance Office, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China |
|
|
|
Abstract Objective To analyze the impact of the medical separation reform in April 2017 on the medical expenses of patients in grade tertiary hospitals in Beijing, and to provide advice on medical cost management and medical service pricing reform. Methods Descriptive analysis method was used to analyze the medical cost data of Beijing grade tertiary hospitals from 2014 to 2018, and Patients′ costs before the reform (2014-2016), during the reform (2017) and after the reform (2018) were compared. Results After the reform of separating medicine from medicine, the average cost of outpatient service and hospitalization in tertiary hospitals increased by 2.65% and 2.44% respectively, and the proportion of outpatient and inpatient drugs decreased to 55.67% and 26.54% respectively, and the proportion of inpatient materials expenses decreased to 32.43%. The proportion of hospitalization expenses covered by medical insurance was 72.54%. Conclusion After the reform of separating medicine from medicine, the level of medical expenses in tertiary hospitals has been increased in a controllable way, the medical cost structure has been optimized, and the medical burden on patients has been steadily reduced. It is suggested that we should continue to deepen the reform of medical price, standardize and adjust the medical service fees, and strengthen the control of the growth of medical expenses, so as to better realize the transformation of hospital compensation mechanism.
|
|
|
|
|
|
[1] 北京市人民政府.关于印发《医药分开综合改革实施方案》的通知.京政发[2017]11号[Z]2017-03-22.
[2] 北京市卫生和计划生育委员会.北京市医药分开综合改革的背景和意义[EB/OL].（2017-03-24）[2019-9-25].http：//www.bjchfp.gov.cn/zwgk/zcjd/201703/t20170325_ 212682.html.
[3] 舍曼·富兰德，艾伦·C·古德曼，迈伦·斯坦诺.卫生经济学[M].6版.北京：中国人民大学出版社，2011.
[4] 北京市统计局，国家统计局北京调查总队.北京市2014年国民经济和社会发展统计公报[EB/OL].（2015-02-12）[2019-9-25].http：//tjj.beijing.gov.cn/tjsj/tjgb/ndgb/201511/t20 151124_327764.html.
[5] 北京市统计局，国家统计局北京调查总队.北京市2015年暨“十二五”时期国民经济和社会发展统计公报[EB/OL].（2016-02-15）[2019-9-25].http：//tjj.beijing.gov.cn/tjsj/tjgb /ndgb/201603/t20160329_346055.html.
[6] 北京市统计局，国家统计局北京调查总队.北京市2016年国民经济和社会发展统计公报[EB/OL].（2017-02-25）[2019-9-25].http：//tjj.beijing.gov.cn/tjsj/tjgb/ndgb/201702/ t2017 0227_369467.html.
[7] 北京市统计局，国家统计局北京调查总队.北京市2017年国民经济和社会发展统计公报[EB/OL].（2018-02）[2019-9-25].http：//tjj.beijing.gov.cn/tjsj/tjgb/ndgb/201803/P020 180302397365111421.pdf
[8] 北京市统计局，国家统计局北京调查总队.北京市2018年国民经济和社会发展统计公报[EB/OL].（2019-03-20）[2019-9-25].http：//tjj.beijing.gov.cn/tjsj/tjgb/ndgb/201903/t20 19319_418980.html.
[9] 北京市卫生和计划生育委员会.关于印发《北京市公立医院提质增效控费关键绩效指标管理方案》的通知[EB/OL].（2017-03-22）[2019-09-25].http：//wjw.beijing.gov.cn/wgk/ztzl/yyfkzhgg/zcwj/201703/t20170322_212458.html.
[10] 杨朔，庄昱，周书铎，等.北京市医药分开综合改革对二三级公立医院经济运营状况的影响[J].中国卫生经济，2019，38（3）：19-22.
[11] 邓婕，邹俐爱，宋喜国，等.医药分开综合改革对公立医院经济运行质量的影响：以医疗费用为中介变量术[J].中国卫生经济，2017，36（12）：13-17.
[12] 谢其鑫，程薇，倪敬年，等.某市三级甲等中医医院阿尔茨海默病门诊费用及医改前后变化分析[J].中国医药导报，2019，16（3）：44-48.
[13] 中共北京市委，北京市人民政府.关于印发《“健康北京2030”规划纲要》的通知.京发[2017]19号[Z]2017-09-07.
[14] 饶克勤.公立医院筹资与补偿机制[J].中华医院管理杂志，2015，31（3）：161-163.
[15] 刘微，庄倩.北京市医药分开综合改革前后公立医院医保患者医疗费用结构变化分析[J].解放军医学院学报，2019，40（6）：600-604.
[16] 崔婷婷，熊季霞.江苏省综合医院人均医疗费用预测分析[J].中国医药导报，2017，14（16）：138-141.
[17] 马丽文，宫春博.山东省公立医院医疗费用控制效果分析[J].中国医药导报，2019，16（25）：171-174.
[18] 赵琳.医药分开改革前后某医院住院患者费用分析[J].中国病案，2019，20（11）：69-72.
[19] 陈稚林，李卓，宋秀红.公立医院推行医药分开中存在的问题及应对策略[J].中国药物与临床，2018，18（2）：296-298.
[20] 庄昱，周书铎，杨朔，等.北京市医药分开综合改革对门急诊费用控制的机制研究[J].中国卫生政策研究，2017， 10（12）：9-14.
[21] 任在方.谋定而后动：以绩效考核撬动医院整体改革[J].中国医院院长，2019（11）：70-71. |
|
|
|
