CAJ | 학술논문

目的了解浙江省县级公立医院综合改革政策实施效果,为改进改革措施、保证改革的有效性和可持续性提供参考依据.方法选择2012年12月启动改革的38家综合型医院作为研究对象,收集其2012年1～6月和2013年1～6月的各项绩效指标,分析改革前、后的绩效变化情况.结果浙江省县级公立医院实施综合改革政策后,医疗服务数量明显提高,门急诊总收入和住院总收入增加,药品收入比例下降(由54.41％下降至49.30％);次均门急诊费用增加(年均增长0.75％),次均住院费用减少(年均降低1.41％);医务人员收入提高(增长6.04％),医院收支结余增加.结论通过改革减轻了患者的药品负担,但对医生处方行为及减轻患者看病总体负担的作用,值得进一步研究.
목적 료해절강성현급공립의원종합개혁정책실시효과,위개진개혁조시、보증개혁적유효성화가지속성제공삼고의거.방법 선택2012년12월계동개혁적38가종합형의원작위연구대상,수집기2012년1～6월화2013년1～6월적각항적효지표,분석개혁전、후적적효변화정황.결과 절강성현급공립의원실시종합개혁정책후,의료복무수량명현제고,문급진총수입화주원총수입증가,약품수입비례하강(유54.41％하강지49.30％);차균문급진비용증가(년균증장0.75％),차균주원비용감소(년균강저1.41％);의무인원수입제고(증장6.04％),의원수지결여증가.결론 통과개혁감경료환자적약품부담,단대의생처방행위급감경환자간병총체부담적작용,치득진일보연구.
Objective To probe into reform outcomes of county-level public hospitals in the province,for the purpose of improving reform measures and ensuring validity and sustainability of the reform.Methods 38 general hospitals with ongoing reform since December 2012 were rounded up in the research.From these hospitals the performance indicators of January-June,2012 and January-June,2013 were collected and analyzed for comparison before and after the reform.Results The reform found a significant rise of medical services,an increase in the revenue of both outpatients and inpatients,and a proportional drop of drug sales(from 54.41％ to 49.30％); an increase of outpatient costs per visit (0.75％average annual increase); a drop of hospitalization fees per person(1.41％ average annual decrease); an increase of medical workers' income (6.04％ increase); and a budget surplus for the hospitals.Conclusion The comprehensive reform has reduced medicine cost burden for patients,yet its role in regulating physicians' prescription behavior and alleviating the general out-of-pocket burden of patients in general remains to be confirmed.