广州市就医病人流向与费用分析

目的 配合广州市医疗保障制度改革，分析就诊病人流向和医疗费用。方法 收集广州城区63所医院1995-1998年的卫生统计年报和财务报表，对比各级医院门诊和住院病人及人均医疗费用增长情况。结果 级别高的部属和省属医院收治病人比例逐年上涨，级别低的区属和集体所有制医院收治比例逐年下降；人均医疗费用快速增长，不同级别医院间差距明显，最高者超过最低者一倍有余。结论 病人就诊流向存在较大的不合理性，卫生资源浪费严重，是社保基金安全运作的潜在危险因素。

Analysis of Flow Direction of Patients and Medical Expenses in Guangzhou City

Objective To analysis the flow direction of patients seeking medical advice and the medical expenses in order to coordinate the reform of medical insurance system. Methods Annual forms of health statistics and financial statements in 63 hospitals in Guangzhou proper from 1995 to 1998 are collected. An increase in outpatients and inpatients, and that in per capita medical expenses in hospitals at all levels are contrasted respectively. Results The proportion of treated patients in hospitals affiliated to the ministry and in provincial hospitals presents going up year after year, and that in district and collective ownership hospitals presents going down year after year; Per capita medical expenses increase rapidly, but the difference in different level hospitals is remarkably significant, the highest is over twice than that the lowest. Conclusion There exists much unreasonableness in the flow direction of patients seeking medical advice. Great loss of health resources will be a potential dangerous factor for social insurance fund operation.