基于结构变动度的不同付费方式住院医疗费用控制研究

目的 探讨住院医疗费用的结构构成,分析不同付费方式下影响费用结构变动的趋势与特征,为控制住院医疗费用不合理增长提供循证依据。方法 采用结构变动度、结构变动值和结构变动贡献率等指标进行统计分析。结果 住院医疗费用结构变动度达7.84%,以2012—2013年变动振幅较大;药品费、治疗费、化验费是引起结构变动的主要项目,三者累计贡献率为78.38%;其中化验费和治疗费呈持续正向变动,药品费呈持续负向变动。结论 控制住院医疗费用应结合不同付费方式分类制宜,药品费和检查化验费比重过高,而体现医护人员医疗服务价值的诊疗手术费等过低,费用结构有待优化,医疗服务价格与支付制度改革势在必行。

Research on the Medical Expenses Control of Different Payment Methods Based on Structure Variation Degree

Objective To explore the structure of hospital costs, we analyze the tendency and characteristics of the structure change that influenced by the hospitalization expenses under different payment,so providing the evidence for the control of unreasonable growth of medical expenses. Methods The indexs of structural variation,degree of structural variation, and contribution rate of structural variation was used for statistical analysis. Results The index of structural variation for hospitalization expenses is 7.84% and there was a great change in 2012-2013. Drug charges, treatment fees, test fees are the main items of the structural variation, the cumulative contribution rate of the three items is 78.38%, and the testing and treatment costs show positive changes but drug charges show negative changes continuously. Conclusion Control of hospitalization expenses should be combined with the classification according to different payment methods. Drug charges and testing costs have too high proportion, while the value of health care personnel medical services is too low. The cost structure needs to be optimized,and the reform of medical service price and the payment system is imperitive.