摘要
目的分析取消药品加成后患者住院费用及医院收入的变化。方法收集广西某三甲医院4个病种住院患者的病案资料。以2014年10月8日至2015年10月7日为药品加成期,2015年10月8日至2016年10月7日为取消药品加成期,分析取消药品加成前后各项住院费用及医院收入的变化情况。结果(1)取消药品加成后,儿科支气管肺炎、内科2型糖尿病的人均住院总费用较前增加,白内障摘除伴人工晶体一期置入术及痔结扎术的人均住院总费用较前有所减少;4个病种的综合医疗服务费均明显增加,除2型糖尿病外,其他3个病种的材料费也较前明显增加;儿科支气管肺炎、2型糖尿病的药品费涨幅较小,但所占比重降低,其他两个病种的药品费较前明显降低。(2)取消药品加成后,全院出院人数、门诊量、手术量较前增加,全院药品收入减少12.10%,全院总收入减少了0.37%。结论取消药品加成后,住院患者的药品费用降低,但材料费与综合医疗服务费仍在上涨,原有药品费用改革政策有待优化。取消药品加成对医院收入有一定的影响,地方政府应建立相应的财政补偿机制。
Objective To analyze the changes of patients′ hospitalization expenses and hospital revenue after implementation of the zero-markup drug policy. Methods The medical record data of the inpatients suffering different 4 diseases in a Grade-Ⅲ Class-A hospital of Guangxi Province were collected. The duration between October 8th,2014 and October 7th,2015 was defined as markup drug period,and the duration between October 8th,2015 and October 7th,2016 as zero-markup drug period.Then the changes of each hospitalization expense and hospital revenue before and after implementation of the zero-markup drug policy were analyzed. Results (1)After implementation of the zero-markup drug policy,the total hospitalization expense per capita increased in the pediatric bronchoalveolitis and type 2 diabetes mellitus of internal medicine,but decreased in the cataract extraction combined with one-stage intraocular lens implantation and hemorrhoids ligation;the comprehensive service expenses of the 4 diseases significantly increased,the material expenses of the other 3 diseases also increased except type 2 diabetes mellitus;the slightly increased drug expense but the reduced proportion of drug expense were observed in the pediatric bronchoalveolitis and type 2 diabetes mellitus,and the drug expenses of the other 2 diseases decreased remarkably.(2)After implementation of the zero-markup drug policy,the number of discharged patients,outpatient volume,and surgical amount of the hospital increased,but the drug revenue and total revenue of the hospital decreased by 12.10% and 0.37%,respectively. Conclusion After implementation of the zero-markup drug policy,inpatients′ drug expense decreases,but the material expense and comprehensive service expense still increase,therefore,it is necessary to optimize the existing reform policy of drug expense.For implementation of the zero-markup drug policy affects the hospital revenue to a certain degree,local government should formulate a corresponding financial compensation policy.
作者
杨翠连
黄振宇
王晓龙
彭蓉
潘超平
黎燕宁
YANG Cui-lian;HUANG Zhen-yu;WANG Xiao-long;PENG Rong;PAN Chao-ping;LI Yan-ning(School of Information and Management,Guangxi Medical University,Nanning 530021,China;Department of Quality Control,Liuzhou General Hospital,Liuzhou 545006,China)
出处
《广西医学》
CAS
2019年第11期1415-1418,共4页
Guangxi Medical Journal
关键词
取消药品加成
住院费用
医院收入
广西
三甲医院
The zero-markup drug policy
Hospitalization expenses
Hospital revenue
Guangxi
Grade-Ⅲ Class-A hospital
