摘要
目的分析县级公立医院改革对浙江省县级公立医院患者住院次均费用的影响,探讨主要变动因素,并提出相应的政策启示。方法采用灰色关联法和结构变动度分析,定量评价2010—2014年住院费用各因素之间的关联程度和结构变动。结果 5年间住院患者的各项费用中,药费的关联度最大(1.000 0),其次是以卫生材料费和化验费为主要构成的其他费(0.878 1);药费的结构变动贡献率最大(47.50%),其次是其他费(36.46%),两者的累计贡献率为83.96%。结论药品费用占住院次均费用比例明显下降,其他费用明显上涨,手术费等体现医务人员劳务价值的收费项目对住院次均费用变动的影响程度较改革前亦未明显提高。建议强化"三医联动",破除医院逐利机制,深入推进优质医疗资源下沉,提升县级公立医院技术水平。
Objective To analyze the influence of the public hospital reform at the county level on average hospitalization expense per time in Zhejiang provincial public hospital reform at the county level,to investigate the main dependent variable and to come up with correlated policy implication. Methods Use the gray relevancy analysis and the structure variation analysis were used to quantitatively evaluate the correlation and structure variation of the hospitalization expense factors from 2010 to 2014. Results Among various hospitalization expenses in 5 years,medicine expenses are most closely linked to the hospitalization expense（1.000 0）. Second on the list is the other expenses which mainly consist of health material expenses and laboratory test expenses. The medicine expenses contribute mostly to the degree of structural variation（47.50%）. Second on the list is the other expenses（36.46%）. The accumulated contribution of this two expenses is 83.96%. Conclusion There is a significantly decrease on the medicine expenses proportion of average hospitalization expense per time. There is a significantly increase on the other expenses. The influences of operation expenses and other expenses which reflect medical staffs＇ labor value to the average hospitalization expense per time are not significantly increased compared to those before the reform. It is advised that we reinforce tripartite sector reform,break the hospital profit pursuit mechanism, deeply promote high quality medical resource available to more people at the grass roots level and improve the technique of Zhejiang provincial hospital reform at the county level.
出处
《中国医院管理》
北大核心
2016年第1期63-65,共3页
Chinese Hospital Management
关键词
住院次均费用
灰色关联
结构变动度
average hospitalization expense per time
gray relevancy analysis
degree of structure variation
