医改前后北京市医疗机构费用及药品费用比较分析

摘要

Objective:To analysis the flow direction and the trend of medical institution exponses and drug expenses of Beijing before and after the health care reform.Methods:Using the method of case lihrary to caloulate total medical institution expenses.Results:After the health care reform,the average annual growth rate of the hospital's expenses was 16.44％.The proportion of city hospital maintained over 87％ before and after the health care refom.After the health care reform,the average growth rate of primary health care institutions" expenses was 16.40％.The community health services" expenses grow 19.34％ annually,The proportion rose from 70.91％ to 80.53％ after the health reform and the proportion of dinic and village health room's expenses decreased.After health care reform,the growth rate of drug's exsxmes was 16.65％,The proportion of expenses of hospital's drug reduced from 57.55％ to 47.34％ during 2009 to 2014.The expernsea flowing to drug stores and primary medical health institutions were increasing year by year,The proportion of drug stores" expenses increased from 35,11％ to 44.44％ during 2009 to 2014.Condusion:City hospitals play a very essential role in Beijing's health system.The number of out patient departments,clinics and village health rooms decreased during the health care reform.After the health care reform,drug expenses flowed into drug stores and primary health institutions.%目的:对比分析医改前后北京市医疗机构费用及药品费用的流向及变化趋势.方法:利用个案库汇总的方法核算机构法卫生总费用.结果:医改后医院费用增速为16.44％,医改前后城市医院占医院费用比重均在87％以上;医改后基层医疗卫生机构费用平均增长速度为16.40％,其中社区卫生服务中心的费用平均增速达19.34％;医改后社区卫生服务中心费用占比从70.91％增长到80.53％,门诊部、诊所、村卫生室费用占比均出现下降;医改后,药品费用增速为16.65％,快于医改前,同时流向医院的药品费用占比逐年下降,由2009年的57.55％下降到2014年的47.34％,而流向药品零售机构和基层医疗卫生机构的费用逐年增多,药品零售机构费用占比由2009年的35.11％增长到2014年的44.44％.结论:城市医院在北京市医疗卫生服务体系中占有重要地位.门诊部、诊所、村卫生室等基层卫生服务机构在医改期间数量减少.医改之后,药品费用流向基层和药品零售机构.