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王文娟,陈心怡,蔡媛青,等.北京市医药分开与医耗联动综合改革对DRG试点医院住院费用的影响研究*[J].中国卫生经济,2023,42(1):19-24,28.[点击复制] |
WANG Wen-juan,CHEN Xin-yi,CAI Yuan-qing,et al.Research on the Impact of the Integrated Reform of Medical-Pharmaceutical Separation Reform and Medical Consumables Linkage Reform on the Hospitalization Costs of DRG Pilot Hospitals in Beijing[J].CHINESE HEALTH ECONOMICS,2023,42(1):19-24,28.[点击复制] |
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| 北京市医药分开与医耗联动综合改革对DRG试点医院住院费用的影响研究* |
| 王文娟,陈心怡,蔡媛青,梁娟娟,胡洋溢,曹馨彤 |
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| (中央财经大学政府管理学院 北京 100081;中国社会科学院中国社会科学评价研究院 北京 100732) |
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| 摘要: |
| 目的：分析北京市DRG试点医院在医药分开与医耗联动综合改革(以下统称两轮综合改革)前后住院费用的变化情况，探讨两轮综合改革实施的效果及存在的问题。方法：收集2017年1月—2019年12月北京市DRG试点医院的住院费用数据，利用间断时间序列分段回归模型，分析患者住院费用的瞬时和趋势变化情况。结果：阶段性结果和间断时间序列结果显示，患者的住院费用总体保持稳定，短期下降后有回升趋势，次均费用中次均药品费占比、次均材料费占比明显下降； 住院总费用中手术费占比显著上升。结论：两轮综合改革对北京市DRG试点医院住院费用内部结构优化具有显著的干预效果， 医务人员技术劳动价值逐步体现，但长期来看住院次均费用仍呈增长趋势发展，药品费和耗材费的改革需持续被关注。 |
| 关键词: 医药分开综合改革 医耗联动综合改革 按疾病诊断相关分组 北京 |
| DOI： |
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| 基金项目:国家社会科学基金青年项目(22CGL052)；国家自然科学基金项目(71473284) |
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| Research on the Impact of the Integrated Reform of Medical-Pharmaceutical Separation Reform and Medical Consumables Linkage Reform on the Hospitalization Costs of DRG Pilot Hospitals in Beijing |
| WANG Wen-juan,CHEN Xin-yi,CAI Yuan-qing,LIANG Juan-juan,HU Yang-yi,CAO Xin-tong |
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| Abstract: |
| Objective: To analyze the changes of average inpatient cost before and after medical-pharmaceutical separation reform and medical consumables linkage reform in the DRG pilot hospitals in Beijing，and to explore the effects and problems of these two rounds of medical reform. Methods: The inpatient cost data of Beijing DRG pilot hospitals from January 2017 to December 2019 were collected. The instantaneous and long-term trend changes of the average cost of inpatients were analyzed based on the segmented regression model of interrupted time series. Results: The results showed that the average cost of inpatients remained stable on the whole，and there was a rising trend after a short-term decline. The proportion of drugs and materials per person in average cost per person decreased significantly，and the proportion of surgical costs in hospitalization costs increased significantly. Conclusion: These two rounds of comprehensive medical reforms had a significant intervention effect on the optimization of the internal structure of the hospitalization cost in the DRG pilot hospitals in Beijing，and the value of the technical labor of the medical staff was gradually reflected. However，in the long run，the average cost per person was still growing. It was needed to continue to pay attention to the reform of the drug and consumable costs. |
| Key words: medical-pharmaceutical separation reform medical consumables linkage reform Diagnosis Related Groups Beijing |
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