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目的通过分析某三甲医院神经内科医药分开前后脑血管病的疾病谱和关键医疗效率指标的变化情况,了解医院医药分开的实施效果,为医院管理者提供决策依据和线索。方法采用描述统计和推断统计分析方法,对2017年4月8日-2017年5月31日及2016年4月9日-2016年6月1日疾病谱和药占比等指标进行对比分析。结果医药分开前后神经内科脑血管病的病种构成分布相同(P>0.05),次均药费和平均药占比有所降低(P<0.05),改革前后次均药费分别为7414.37元、5999.80元,平均药占比分别为39.38%、31.18%,较改革前同期分别平均下降1414.57元和8.20%。结论医药分开已经使该院神经内科脑血管病药占比有了一定下降,还有继续下降空间。医疗改革需要可持续性,并让医院医师和患者尽可能满意。
Objective To analyze the changes of the disease spectrum and key medical efficiency indexes of cerebrovascular disease before and after the separation of neurology and internal medicine in a top three hospital so as to understand the effect of the separation of hospital medicine and provide decision basis and clue for hospital managers. Methods The methods of descriptive statistics and inferential statistical analysis were used to compare and analyze the indicators of disease spectrum and medicine proportion from April 8, 2017 to May 31, 2017 and April 9, 2016 to June 1, 2016 respectively. Results Before and after the medicine was divided, the distribution of disease types in neurology and cerebrovascular disease was the same (P> 0.05), and the proportion of the average drug and the average medicine was decreased (P <0.05). The average charges before and after the reform were 7414.37 yuan, 5999.80 yuan, the average drug accounted for 39.38%, respectively, 31.18% over the same period prior to the reform, an average decrease of 1414.57 yuan and 8.20%. Conclusion The separation of medicine has made the proportion of cerebrovascular medicine in neurology department of the hospital decreased to a certain extent, and there is still room for further decline. Health care reform needs sustainability, leaving hospital doctors and patients as satisfied as possible.