医疗服务价格调整对医院业务收入的影响

目的为了解公立医院实行药品零差价后，医疗服务价格调整政策的实际补偿水平以及价格调整后对综合性医院收入总额及收入结构，次均费用的影响。方法以宁波市第一医院2014年1—3月实际业务量数据为基础，通过新旧价格对比计算的方法，反映新政策的补偿率。另外通过对比2013年同期业务数据反映新政策调整后收入总额、收入结构、次均费用、就医人次的变化。结果医疗服务价格调整政策的实际补偿率为132%。对比2013年同期业务数据显示：医疗业务总收入增长，平均增长约8%；每人次费用增长；每人次门诊药费基本持平，住院药费明显下降；门诊就医人次减少，住院就医人次增加。讨论实行药品零差价后通过医疗服务价格调整进行补偿，按照浙江省方案，补偿已经到位且略有盈余。医疗服务价格的调整优化了医疗收入结构，体现医务人员劳动价值，但没有真正减轻患者的负担。建议进一步完善医疗服务价格调整政策，降低部分大型医疗设备检查及检验项目的价格。同时财政参与调整后的补助，有利于在保障医疗机构正常经营和减轻患者就医负担之间寻求平衡点。

The Study on the Effect of Medical Services Price Adjustment on the Income of Hospitals

Objective To learn the actual offsetting status and study the effects of zero-markup drug sale on the total income, income structure and average service fee in public hospitals. Methods Based on the business data from January to March, 2014 in Ningbo First Hospital, comparison with old and new medical service price was done to reflect the compensation rate of new price policy. Furthermore, comparison was conducted between the current business data and that during January to March in 2013 to find out the the change in gross income, income structure, average fees and the number of people hospitalized. Results The actual compensation rate is 132%after the price adjustment. The total income is rising with an average rate of 8%, average fees is increasing too, drug fees of outpatient is nearly the same and inpatient is declining, the number of outpatient is on decline and that of inpatient is on rise. Conclusion According to program of Zhejiang province, the compensation after the implementation of adjustment in medical service price is already enough with a little surplus. The adjustment has optimized income structure and embodied the value of medical workers, but not yet decreased burden of patient. We suggest government improving the price policy, lower the price of examination with major medical equipment. Meanwhile the participation of finance institutions in compensation after policy adjustment is beneficial to balancing between normal operations of hospital and reduction of patients＆#39; burden.