成渝泸区域医疗费用变化趋势及结构变动分析

目的]分析成渝泸区域医疗费用结构变动情况,为推动成渝泸区域联动控制医疗费用不合理增长提供科学参考。方法]采用结构变动度分析法评价成渝泸区域医疗费用变化及结构变动情况。结果]重庆市、成都市和泸州市的门诊病人次均医药费用年均增长率分别为6.37%、6.75%和6.19%,出院病人人均医药费用年均增长率分别为2.89%、3.22%和1.69%。门诊病人费用中,重庆市、成都市和泸州市药费的结构变动值为负数,呈负向变动,结构变动度为2.12%~7.35%。出院病人费用中,整体结构变动值为正数,呈正向变动,重庆市2016年的结构变动度最高(19.41%),成都市和泸州市2017年的结构变动度最高(8.45%和9.08%)。门诊病人费用中,重庆市、成都市和泸州市的药费贡献率均超过40%,结构变动活跃。住院病人费用中,重庆市、成都市和泸州市的药费贡献率超过46%,结构变动活跃。结论]成渝泸区域医疗费用差异显著,药品费用结构变动活跃,检查治疗费各地区的活跃程度不一致。建议成渝泸区域建立医疗费用一体化监控体系,加强药品零差价政策后的配套措施,加强精细化管理。

Analysis on the change trend and structural change of medical expenditure in Cheng-yu-Lu area

Objective Analyze the structural change of medical expenses in Cheng-yu-lu area so as to provide scientific basis for promoting gang control for the unreasonable growth of medical expenses in Cheng-Yu-lu area.Methods The structural change degree analysis method was used to evaluate the changes structural changes of medical expenses in Cheng-yu-Lu area.Results The average annual growth rate of medical expenses for per-person outpatient in Chongqing,Chengdu and Luzhou was 6.37%,6.75%and 6.19%,respectively.The average annual growth rates of medical expenses for per capita discharged patient in Chongqing,Chengdu and Luzhou was 2.89%,3.22%and 1.69%,respectively.In the outpatient expenses,the structural change value of drug cost in Chongqing,Chengdu and Luzhou was negative,which indicated negative change,and changing range was from 2.12%to 7.35%.In the expenses of discharged patient,the overall structural change value was positive,which showed positive change;The highest structural change in Chongqing in 2016 was 19.41%,and the highest in Chengdu and Luzhou was in 2017,which reached 8.45%and 9.08%,respectively.In outpatient expenses,the contribution rate of drug expenses in Chongqing,Chengdu and Luzhou was over 40%,with active structural change.In inpatient expenses,the contribution rate of drug expenses in Chongqing,Chengdu and Luzhou was over 46%,with active structural change as well.Conclusions There are significant differences in medical expenses in Chengdu,Chongqing and Luzhou,and with active structural change in drug expenses,the activity level of examination and treatment expenses is different in different regions.It is suggested that set up medical expenditure integration supervision and control system for strengthening the supporting measures after drug zero price difference policy and delicacy management.