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降低药占比对我院医疗服务体系运行状况及患者医疗费用的影响
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| 篇名： | 降低药占比对我院医疗服务体系运行状况及患者医疗费用的影响 |
| TITLE： | |
| 摘要： | 目的：为深入理解控制药占比的意义和明确医院后续改革方向提供参考。方法：调取我院2016年8月、2017年6月和8月的相关统计报表数据，分别对全院、门急诊、住院药占比、收入、患者医疗费用、基药品种比、处方量（门急诊）、抗菌药物使用率及使用强度等指标数据进行统计、分析和比较。结果：2017年8月（价改后）我院药占比明显下降，全院环比降幅为13.35％，同比降幅为17.58％。全院收入总体增加（环比增幅为6.92％，同比增幅为11.45％），门急诊收入环比有所减少（减幅为2.73％），住院收入环比则有较明显增加（9.76％）；门急诊患者人均医疗费用有所增加（环比增幅为4.01％，同比增幅为9.62％），而住院患者人均医疗费用有所减少（环比减幅为0.91％，同比减幅为3.11％）。全院国家基本药物品种比环比仅轻微下降，而同比增幅为17.79％；门急诊处方药品总量环比减幅为11.34％，处方量环比减幅为9.16％。全院抗菌药物使用率环比降幅为8.10％；抗菌药物使用强度环比和同比降幅分别为3.88％和13.88％。结论：价改后我院药占比得到有效控制，对我院医疗服务体系运行状况及患者医疗费用均有一定的积极影响。但同时也暴露出了一些亟待解决的问题，如门急诊患者人均医疗费用增加、门急诊患者人数减少等。因此，控制药占比仅仅是医院深化改革迈出的第一步，后续动力仍需通过加强合理用药来持续提供。 |
| ABSTRACT： | OBJECTIVE： To provide reference for understanding the significance of drug proportion control deeply and future direction of hospital reform. METHODS： The data were collected from the relevant statistical reports of our hospital in August 2016， June and August 2017. The data were analyzed statistically and compared in respects of drug proportion， income， medical cost， ratio of essential medicine types， prescription amount （outpatient and emergency department）， utilization rate and utilization density （AUD） of antibiotics in whole hospital， outpatient and emergency department， inpatient department. RESULTS： The drug proportion of our hospital was decreased significantly in Aug. 2017 （after drug price reform）， which fell by 13.35％ from the previous month and 17.58％ year-on-year. Hospital revenues were on the rise， which increased by 6.92％ from the previous month and 11.45％ year-on-year. Outpatient and emergency income was decreased slightly from the previous month （by 2.73％）. Inpatient income was increased significantly from the previous month （by 9.76％）. Per capita medical cost in outpatient and emergency department were increased， which increased by 4.01％ from the previous month and 9.62％ year-on-year； per capita medical cost of inpatients were declined， which fell by 0.91％ from the previous month and 3.11％ year-on-year. The ratio of essential medicine types in the whole hospital was decreased slightly from the previous month but increased by 17.79％ year-on-year. Drug amount of outpatient and emergency prescriptions was decreased by 11.34％ from the previous month and prescription amount decreased by 9.16％ year-on-year. The utilization rate of antibiotics in the whole hospital was decreased by 8.10％ from the previous month； AUD was decreased by 3.88％ from the previous month and 13.88％ year-on-year. CONCLUSIONS： After drug price reform， drug proportion of our hospital is effectively controlled， which has a positive influence on the operation of medical service system and patient medical cost. At the same time， some problems that need to be solved are also exposed， such as increase in per capita medical costs and the decrease in the number of outpatient and emergency patients. So， drug proportion control is only the first step in deepening hospital reform， and the follow-up motivation still needs to be provided continuously through strengthening rational drug use. |
| 期刊： | 2018年第29卷第6期 |
| 作者： | 邓鋆，覃佳佳，黄淑贤，贺巍，喻珊珊，钟小斌 |
| AUTHORS： | DENG Jun，QIN Jiajia，HUANG Shuxian，HE Wei，YU Shanshan，ZHONG Xiaobin |
| 关键字： | 医药价格改革；药占比；医疗服务体系运行；医疗费用；影响；合理用药 |
| KEYWORDS： | Drug price reform； Drug proportion； Operation of medical service system； Medical cost； Influence； Rational drug use |
| 阅读数： | 789 次 |
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