综合医疗改革对三甲中医院不同类别药品费用的影响分析

目的以某中医三级甲等医院为例,分析公立医院综合改革对三甲中医院不同类别药品费用的影响,讨论药品费用的变化情况。方法对政策前后的西药费、中成药费及中药饮片的次均费用及药占比进行比较分析。结果政策实施后,次均门诊药品费及次均住院药品费分别下降3.98%、2.67%,均次门诊药费比、均次住院药费比均大幅下降6.20%和7.65%,次均中成药费、次均西药费比、次均中成药费比都明显降低(P<0.05),而次均中药饮片费比明显增加(P<0.05),但是住院中的次均西药费比(25.43%)远远高于次均中药饮片比(2.13%)。结论公立医院综合改革减轻了患者药费负担,在一定程度上提高了中医药的竞争力,推进了中医药事业的发展,但中药占比仍偏低,还需促进中西药相对均衡发展。

Analysis on the Influence of Comprehensive Medical Reform on Different Kinds of Drug Expenses in Traditional Chinese Hospitals of Class A and Grade Three

Objective:Taking a hospital of traditional Chinese medicineof Class A and Grade Three as an example,this paper analyzes the influence of comprehensive reform in public hospitals on different kinds of drug expenses,and discusses the changes of drug expenses.Method:Before and after the policy implementation,the western medicine expense,the expense of Chinese medicine,and the average expense and the proportion of Chinese medicine decoction pieces were compared and analyzed.Result:After the implementation of the policy,the average outpatient drug fee and the average in-patient drug fee decreased by 3.98%and 2.67%respectively.The average outpatient drug expense ratio and the average in-patient drug expense ratio decreased significantly by 6.20%and 7.65%.The average expense of Chinese medicine per time,the average expense ratio of western medicine per time and the average expense ratio of Chinese medicine per time were all significantly reduced(P<0.05),while the average expense of Chinese medicine decoction pieces per time was significantly increased(P<0.05).However,the average expense ratio of western medicine per time(25.43%)was much higher than that of Chinese herbal medicine per time(2.13%).Conclusion:The comprehensive reform of public hospitals has reduced the burden of patients’drug expenses.To some extent,the competitiveness of traditional Chinese medicine has been improved.However,the proportion of traditional Chinese medicine is still low,and it is necessary to promote the balanced development of Chinese medicine and western medicine.