补偿机制改革对山东省某县级公立医院住院服务的影响

目的 分析补偿机制改革对县级公立医院住院患者住院服务的影响,为进一步完善补偿机制改革提供建议和依据。 方法 选择糖尿病、肺炎、阑尾炎和腰间盘突出4类常见疾病,运用间断时间序列的分段回归模型,分析山东省某县级公立医院住院患者的住院费用、住院天数和手术率在2014年10月1日改革前后的即时变化和趋势变化。结果 补偿机制改革后,该县级公立医院住院患者的次均住院药品费用和医疗服务费用变化有统计学意义;住院患者次均住院总费用、耗材费用、诊断费用变化无统计学意义;住院天数和手术率变化无统计学意义。 结论 尽管补偿机制改革降低了住院患者的药品费用,但尚未能有效抑制住院患者住院总费用的快速上涨及其他指标变化。

Influence of compensation mechanism reform on the hospitalization expenses of a county-level public hospital in Shandong Province

Objective To analyze the impact of compensation mechanism reform on the per-visit inpatient services in a county-level public hospital in Shandong Province, and offer evidence for further development and adjustment of the reform. Methods Interrupted time series segmented regression model was used to analyze the instant change which took place on October 1, 2014 and trend of per-visit inpatient expense, hospital stay and surgical rate, based on data of diabetes, pneumonia, appendicitis and lumbar discherniation collected from a county-level public hospital in Shandong Province. Results After the reform, there were statistically significant in the changes of inpatient drug expense and medical service expense in this hospital; there were no statistical significance in the changes of per-visit inpatient expense, medical consumables expense and diagnosis expense; there were no statistical significance in the changes of hospital stay and surgical rate. Conclusion Although compensation mechanism reform reduces the per-visit inpatient drug expense, the trend of rising inpatient expense and other indicators have not been effectively controlled.