收支两条线对降低居民就诊费用的效果分析

目的了解收支两条线对缓解看病难、看病贵的作用。方法纵向和横向比较分析收支两条线在改革前后试点社区卫生服务中心次均门诊费用的变化情况。结果2006年次均门诊费用与2005年同期比较,下降了10.7%～37.6%,试点中心门诊费用与对照社区卫生服务中心和其他医疗机构比较,差异均有显著性意义(P<0.05)。结论实行收支两条线管理,能够降低居民就诊费用,有效缓解看病难、看病贵的问题。而在改革的过程中,一个决定成败的关键,即保证政府投入资源使用的效率,建立和完善社区卫生服务竞争机制和评估机制,强化和确保公益性的可持续性。

Effect on Decreasing Residents'''' Expenses of Medical Care from Both Revenues and Expenditures

Objective To investigate the effect from both revenues and expenditures on relieving the difficulties and expensiveness for seeking medical care.Methods Comparatively analyzing the variation before and after reform in both revenues and expenditures of outpatient expense per capita in pilot community health service(CHS) centers in longitudinal and sectional approaches.Results The outpatient expense per capita in 2006 decreased by 10.7%~37.6% as compared with that in 2005 in pilot CHS centers.There was a significant difference between the pilot CHS centers and the control CHS centers or other medical institutions(P<0.05).Conclusion Implementation of management from both revenues and expenditures could decrease residents' medical expense,efficiently relieve the difficulties and expensiveness for seeking medical care.During the reform process,the critical point is to ensure the utilization efficiency of the governmental investments,build up and improve competitive and evaluative mechanism for CHS,and strengthen and guarantee the sustainability of public welfare.