药品零加成政策对医疗费用的影响——以支气管肺炎为例

目的]分析取消药品加成政策对住院次均费用的影响,探讨住院费用的主要影响因素,为减轻患者疾病负担、优化医疗费用结构提供依据。方法]收集广东省茂名市7家三级甲等医院主要诊断为支气管肺炎的住院费用信息,采用新灰色关联法和结构变动度分析,评价住院费用各因素之间的关系及对住院费用影响程度。结果]2014-2018年,住院患者的药占比由34.59%下降为27.46%,检验费占比从24.26%上升为28.42,检查费占比从5.80%上升为7.64%;在影响住院费用的因素中,药品费的关联度最大(0.9960),其次是检验费(0.9594),药品费、检验费、其他费、检查费、治疗费的累积贡献率为84.74%。结论]取消药品加成政策改革初显成效,但仍需控制药品费用。药品费和检查费是影响住院费用的主要项目。

The impact of drug zero addition policy on medical costs--Take bronchial pneumonia as an example

Objective To analyze the impact of eliminating addition on drug policy to the average cost of per hospitalization,and discuss main influencing factors of hospitalization expenses,so as to provide basis for reducing the patient s disease burden and optimizing the structure of medical expenses.Methods It collected hospitalization expenses data of bronchial pneumonia from 7 grade three class A hospital.The new gray correlation method and structural change analysis were used to evaluate the relationship in the factors of hospitalization expenses and the impact on hospitalization expenses.Results From 2014 to 2018,the proportion of inpatients drugs decreased from 34.59%to 27.46%,inspection fee increased from 24.26%to 28.42%,examination fee increased from 5.80%to 7.46%.In influencing factors of hospitalization expenses,the relevancy of drug cost was the biggest(0.9960),followed by the inspection fee(0.9594).The cumulative contribution rate of drug,inspection,other,examination,and treatment fee was 84.74%.Conclusions The policy reform of eliminating addition on drug has achieved initial results,but it still needs to control the cost of medicines.Drug costs and inspection fees are main items affecting hospitalization expenses.