2016-2020年全国患者分流的经济学效益预测

目的：预测2016-2020年，全国三级和二级医院门诊和住院患者分流后能节省的直接医药费用。方法：使用直线趋势外推法，根据2006年-2015年公立一二三级医疗机构门诊人次数、入院人数、门诊病人次均医药费用、住院病人人均医药费用预测2016-2020年相应的情况。然后将不同类型病人的可分流比例分别取10%、20%、30%，计算分流后能够节省的直接医药费用。结果：若2016-2020年卫生服务利用趋势与样本年间一致，三级医院将保持门诊费用与患者人数的快速增长；若分别分流10%（20%，30%）三级与二级医院的患者至二级和一级医疗机构，能节省费用总额8%（16%，24%）。结论：要控制医疗费用的增长，引导患者合理就诊是前提，加强二级医疗卫生机构能力建设是重要举措，同时遵守医疗卫生服务体系建设适应分流比例的原则，还要注意分流目标的可持续性和可行性。

Reduce of Medical Direct Expenses Forecast on National Patients Distributary of China from the Year of 2016 to 2020

Objective: To forecast the reduce of medical direct expenses of China from 2016 to 2020, under the circum stances that some outpatients and inpatients of tertiary hospitals and secondary hospitals can be referred to primary medical institutions. Methods: Data were collected from multiple national health statistic yearbooks in 2006-2015. The number of outpatients, number of inpatients, medical expenses of outpatients per visit, and medical expenses of inpatients per visit were used to forecast corresponding results of these 4 indexes from 2016 to 2020, by using linear regression model. Results: Following the increasing trend of the number of patients and expenses, patients and medical expenses in tertiary hospital will have a sharp growth during 2016 and2020. If 10, 20 and30 percent of patients of tertiary and secondary hospitals can be referred to secondary hospitals and primary medical institutions, total medical expenses can be reduced by 8, 16 and-24 percent, respectively. Conclusion: To slowdown the increasing trend of medical expenses, first priority is to slowdown the visits of outpatient and inpatient. it is an important act to strengthen the capacity of secondary hospitals . Medical care delivery system should match the distributary structure, and the patient distributary should be done step by step.