摘要
目的分析上海市公立医疗机构门诊和住院患者自费外购项目利用状况及其与患者对医疗费用合理性评价的关联性。方法通过对2023年上海市公立医疗机构门诊和住院患者进行问卷调查,分析患者就医时自费外购药械、进行院外检测的实际状况。采用多分类logistic回归模型,分析自费外购药械和院外检测对患者“医院医疗费用合理”认同率的影响。结果2023年上海市公立医疗机构门诊和住院患者就诊中,自费外购药物率、自费外购器械率和自费院外检测率分别不足10%、7%和4%,门诊和住院患者对“医院医疗费用合理”的认同率分别为84.86%和95.75%。此外,自费外购药物和院外检测可降低门诊患者对“医院医疗费用合理”的认同率,自费外购药物和器械可降低住院患者对“医院医疗费用合理”的认同率。结论公立医疗机构应以价值为导向,减少患者不必要的自费外购药械、院外检测。
Objective It was aimed to analyze outpatient and inpatient utilization of self-paid and outsourced items in public healthcare institutions in Shanghai and its association with patient evaluation of medical cost rationality.Methods By conducting questionnaire surveys among outpatients and inpatientsin public healthcare institutions in Shanghai in 2023,patient utilization of self-paid and outsourced medicine,devices and testsin medical care was analyzed.Multilevel logistic regression models were adopted to analyze the influence of patients’self-paid and outsourced medicine,devices and tests on their identification rate with regard to"hospital medical care cost is reasonable".Results In 2023,the rates of outpatient and inpatient utilization of self-paid and outsourced medicine,devices and tests were less than 10%,7%,and 4%,respectively,in public healthcare institutions in Shanghai.The identification rates with regard to“hospital medical care cost is reasonable”in outpatients and inpatients were 84.86%and 95.75%,respectively.Additionally,self-paid and outsourcedmedicine and testscould reduce the identification rate with regard to"hospital medical care cost is reasonable"in outpatients,while self-paid and outsourced medicine and devices could decrease this rate in inpatients.Conclusion Public healthcare institutions should be value-oriented and reduce unnecessary patients’self-paid and outsourced medicine,devices and tests.
作者
王云梦
邹冬冬
周萍
蔡宇晖
陈淑雯
薛迪
Wang Yunmeng;Zou Dongdong;Zhou Ping(School of Public Health,Fudan University,Shanghai,200032,China;不详)
出处
《中国医院管理》
北大核心
2026年第2期33-36,共4页
Chinese Hospital Management
基金
上海医药卫生行风建设促进会资助项目。
关键词
自费
外购药物
器械检验检查
医疗费用
self-paid
outsourcing
medicine
device test
health care cost
