江苏省公立医院补偿机制改革研究

目的分析江苏省公立医院补偿机制改革对医院经济运行、医疗服务提供、医疗费用等方面的影响,为进一步优化有关改革政策、推进公立医院综合改革提供参考和依据。方法收集2014-2016年江苏省卫生统计资料,提取关键指标进行统计分析。结果江苏省公立医院资产负债率总体呈上升趋势,医院经营风险不断增加;药占比明显下降,门诊与住院医药费用增幅逐年降低,医疗费用过快增长趋势放缓;技术劳务性费用占比有所提升,医务人员价值得到体现;财政补助水平仍然较低,科学、合理、可持续的补偿机制尚未建立;患者就医负担并未有效减轻。结论在制定有针对性的财政补助标准的基础上,深化比价研究,对医疗服务价格进行适时动态调整,建立起可持续的公立医院补偿机制;加强医疗、医药、医保各部门之间的配合联动,促进各部门间政策衔接顺畅,进一步完善"三医联动"机制。

Research on the Compensation Mechanism Reform of Public Hospitals in Jiangsu Province

Objective To analyze the impact of the compensation mechanism reform of public hospitals in Jiangsu Province on the economic operation of hospitals,the provision of medical services and medical expenses,so as to provide reference and basis for further optimizing the relevant reform policies and promoting the comprehensive reform of public hospitals.Methods Health statistics of Jiangsu Province from 2014 to 2016 were collected,and key indicators were extracted for statistical analysis.Results The assets-liabilities ratio of public hospitals in Jiangsu Province showed an overall upward trend,and the risk of hospital operation increased continuously.The proportion of drugs decreased significantly,the increase rate of outpatient and inpatient medical expenses decreased year by year,and the trend of excessive growth of medical expenses slowed down.The proportion of technical and labor costs increased,and the value of medical personnel was reflected.The level of financial subsidies was still low,the scientific,reasonable and sustainable compensation mechanism has not been established,and the burden of patients seeking care at public hospitals has not been effectively reduced.Conclusion On the basis of formulating targeted financial subsidy standards,the study of price comparison should be deepened,the price of medical services should be adjusted timely and dynamically,and a sustainable compensation mechanism for public hospitals should be established.The coordination among medical,pharmaceutical and medical insurance departments should be strengthened to promote smooth policy cohesion among relevant departments and to further improve the mechanism of the medical-insurance-medicine linkage.