论文部分内容阅读
目的按照药品零加成调整方案,分析某肿瘤医院2016年6月份出院患者住院费用变动情况,预测药品零加成政策实施后对公立医院的影响,为制定最优的改革方案提供参考,为医院经营战略的调整提供依据。方法将《四川省医疗服务价格调整目录》导入医院HIS系统,根据服务价格代码和HIS系统中的收费明细对照,生成价格调整前后的收费明细对照表。导出某院2016年6月份出院患者的现有和调价后的费用明细以及出院科室、手术情况等信息。运用SPSS 15统计软件对患者的费用类别,出院科室,是否手术等方面进行调价前后医疗费用进行统计分析,分析调价前后医疗费用是否具有显著性差异。结果调价前出院患者人均费用为24 025.84元,调价后23 702.69元,人均减少323.15元,降低幅度1.35%;费用构成上:麻醉费、手术费、治疗费、检查费有所增加,西药费大幅度降低,其他费用没有变化;患者手术情况:手术患者人均费用增加,非手术患者降低,手术患者和非手术患者费用变化幅度都具有统计学意义(P<0.001);患者出院科室:外科、放疗科和肿瘤内科人均费用都有所减少,但是外科出院患者降低幅度最少,放疗科次之,内科降低幅度最大。结论药品零加成政策可以促进医疗费用结构合理化,进一步体现医务人员的劳动价值,缓解医患矛盾有积极意义,然而还要关注药品零加成导致医院的收支失衡,希望相关部门及时制定补偿措施,确保公立医院健康有序发展。
Objective To analyze the changes of hospitalization costs of discharged patients in a tumor hospital in June 2016 in accordance with the adjustment plan for zero-addition of drugs and predict the impact on the public hospitals after the implementation of the policy of zero-addition of drugs, so as to provide a reference for formulating the optimal reform plan, Business strategy to provide the basis for adjustment. Methods The Catalog of Price Adjustment for Medical Services in Sichuan Province was imported into the hospital HIS system. According to the comparison between the service price codes and the charges in the HIS system, a list of charges before and after price adjustment was generated. Export the details of the current and post-price adjustment fees for discharged patients in a hospital in June 2016, as well as information on discharge departments and operation conditions. SPSS 15 statistical software was used to conduct statistical analysis of the medical expenses before and after the price adjustment of the patient’s cost category, discharge department, whether the operation and so on, and to analyze whether the medical expenses before and after the price adjustment have significant differences. Results The average cost of discharged patients before the price adjustment was 24 025.84 yuan, 23 702.69 yuan after the price adjustment, with a per capita decrease of 323.15 yuan and a decrease of 1.35%. The cost structure consisted of an increase in anesthesia fees, operation fees, treatment fees and examination fees, (P <0.001); Discharge department: surgery, radiotherapy; Radiotherapy; Surgery; Radiotherapy; Discharge; Surgical treatment; Radiotherapy Department of Oncology and Oncology per capita costs have decreased, but patients with surgical discharge to reduce the least, followed by radiotherapy, internal medicine, the largest reduction. Conclusion The policy of zero addition of medicines can promote the rationalization of the structure of medical expenses, further reflect the labor value of medical staff and alleviate the contradiction between doctors and patients. However, we should also pay attention to the unbalanced income and expenditure of hospitals caused by zero addition of medicines, and hope that relevant departments can make compensation in time Measures to ensure the healthy and orderly development of public hospitals.