摘要
目的了解医药分开综合改革对北京市某三级甲等综合性医院的影响。方法采用对比分析法,对某医院综合改革前(2016年6-12月)和改革后(2017年6-12月)医院管理系统中的数据进行分析,包括诊疗人次、次均费用、医疗收入、收入结构变化等。对相关数据采用t检验及描述性统计学方法进行分析。结果2017年6-12月比2016年6—12月,某医院门诊诊疗人次下降了12.06%,次均费用增加了31.42元(P<0.05),医保患者门诊次均费用增加了28.51元(P<0.05);住院人次增加了2.94%,次均费用增加了877.71元,医保患者住院次均费用下降了42.87元(P>0.05)。住院患者的平均病例组合指数上升0.01,患者满意度上升4.22个百分点。结论医药分开综合改革后,医院门诊就诊人次下降,住院患者诊治难度有所增加,患者就诊体验有所改善。建议医院进一步加强内涵建设和精细化管理,控制医疗费用的不合理增长。
ObjectiveTo understand the impact of the clinic-pharmacy separation reform on a tertiary hospital in Beijing.MethodsIn a comparative analysis,data in the HIS of the hospital were analyzed in descriptive statistics,covering such data as the number of visits,expense per visit,medical income and income structure change in the period between June and December in 2016 and 2017,and were analyzed by the methods of t test and descriptive statistics as well.ResultsCompared with the same period between June and December in 2016,the number of visits at its outpatient department reduced by 12.06%,expense per visit increased by 31.42 yuan(P<0.05),while the expense per visit of patients with medical insurance increased by 28.51 yuan(P<0.05)between June and December in 2017.The number of hospitalizations at the inpatient department increased by 2.94%,expense per hospitalization increased by 877.71 yuan,and that of patients with medical insurance decreased by 42.87 yuan(P>0.05)between the abovementioned periods.The case mixed index of inpatients rose by 0.01,and patient satisfaction rose by 4.22 percentage points.ConclusionsThis reform has reduced outpatient visits at hospitals,increased the coefficient of difficulty of hospital inpatients,and improved patients′ experiences for medical services.Hospitals are recommended to further their internal management in a fine manner,and curb unreasonable growth of medical expenses.
作者
杨旸
李静怡
王鹏
黄俊
吴江
田宗梅
Yang Yang;Li Jingyi;Wang Peng;Huang Jun;Wu Jiang;Tian Zongmei(Computer Centre,Beijing Shijitan Hospital Affiliated to Capital Medical University,Beijing 100038,China;Case Statistics Office,Beijing Shijitan Hospital Affiliated to Capital Medical University,Bering 100038, China;Patient Service Management Centre,Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038,China)
出处
《中华医院管理杂志》
CSCD
北大核心
2019年第1期15-18,共4页
Chinese Journal of Hospital Administration
基金
国家自然科学基金(71432002).
关键词
医院
公立
医药分开综合改革
收入结构
影响
北京市
Hospital, public
Clinic-pharmacy separation reform
Income structure
Influence
Beijing
