民营医院托管对乡镇卫生院的影响研究

目的分析民营医院托管对乡镇卫生院的影响。方法提取乡镇卫生院托管前后(2014年1月~2018年12月)服务量(门诊人次数、出院人数和医技科室服务量)、费用(次均门诊费用和人均住院费用)和收入(门诊收入、住院收入和药占比)等三个核心维度指标的月度数据,利用Stata/SE 15进行间断时间序列分析。结果与托管前相比,被托管乡镇卫生院在托管后第一阶段(2015年1月-2017年3月),出院人数、放射人次数、人均住院费用、住院收入从托管前的稳定趋势转变为上升趋势(P<0.05);在托管后第二阶段(2017年4月-2018年12月),除人均住院费用和药占比之外的其余指标斜率均呈上升趋势改变(P<0.05)。结论民营医院托管对乡镇卫生院住院服务相关指标和医技科室服务量指标的增加具有较为明显的影响,在此基础上进行的2017年北京市医疗服务价格改革进一步加强了上述效果的显现,政策协同效应明显。

Studying on The Influence of Trusteeing by Private Hospitals on Township Health Centers

Objective To analyze the influence of trusteeing by private hospitals on township health centers.Methods Data of monthly amount of service,expenditure and revenue of township health centers before and after trusteeship was extracted,and analyzed with the interrupted time series analysis by Stata/SE 15.Results In the first-stage of being trusteeing,the admissions,person-time of radiotherapy,per capita inpatients’expenditure and hospitalization income has changed from the stable trend to increasing trend(P<0.05).And in the second stage,except the indexes of per capita inpatients’expenditure and the proportion of drug revenue,other indexes showed a significant slop rises.Conclusion Trusteeing by private hospitals had significant influence on the increase of indicators related with inpatient service and amount of service of technical departments,which was further improved by the reform on healthcare price in Beijing.