中华医院管理杂志
中華醫院管理雜誌
중화의원관리잡지
CHINESE JOURNAL OF HOSPITAL ADMINISTRATION
2014年
12期
881-885
,共5页
北京%医药分开%以药补医%双重差分法
北京%醫藥分開%以藥補醫%雙重差分法
북경%의약분개%이약보의%쌍중차분법
Beijing%Separation of clinic from pharmacy%Compensating physicians by drug-selling%Difference-in-differences method
目的 评价北京医药分开改革的效果.方法 基于北京市12家公立医院城镇职工医保患者改革前、后的统计数据,使用双重差分法.结果 北京市医药分开改革使得试点医院门诊和住院次均药费分别下降约30％、21％,药占比分别下降约9％、4％;门诊和住院次均费用分别下降约19％、8％,其中个人负担部分分别下降约23％、3％;医保基金支付比增加约2个百分点;医院总收入、门诊人次和住院人次的增速分别增加11.0、21.7和42.8个百分点.结论 北京市的医药分开改革降低患者次均药费和医院药占比;减轻患者看病负担;增加医院业务量;未明显增加医保基金支付压力.
目的 評價北京醫藥分開改革的效果.方法 基于北京市12傢公立醫院城鎮職工醫保患者改革前、後的統計數據,使用雙重差分法.結果 北京市醫藥分開改革使得試點醫院門診和住院次均藥費分彆下降約30％、21％,藥佔比分彆下降約9％、4％;門診和住院次均費用分彆下降約19％、8％,其中箇人負擔部分分彆下降約23％、3％;醫保基金支付比增加約2箇百分點;醫院總收入、門診人次和住院人次的增速分彆增加11.0、21.7和42.8箇百分點.結論 北京市的醫藥分開改革降低患者次均藥費和醫院藥佔比;減輕患者看病負擔;增加醫院業務量;未明顯增加醫保基金支付壓力.
목적 평개북경의약분개개혁적효과.방법 기우북경시12가공립의원성진직공의보환자개혁전、후적통계수거,사용쌍중차분법.결과 북경시의약분개개혁사득시점의원문진화주원차균약비분별하강약30％、21％,약점비분별하강약9％、4％;문진화주원차균비용분별하강약19％、8％,기중개인부담부분분별하강약23％、3％;의보기금지부비증가약2개백분점;의원총수입、문진인차화주원인차적증속분별증가11.0、21.7화42.8개백분점.결론 북경시적의약분개개혁강저환자차균약비화의원약점비;감경환자간병부담;증가의원업무량;미명현증가의보기금지부압력.
Objective To evaluate the effect of Beijing' s separation of clinic from pharmacy reform.Methods Use difference-in-difference method based on dataset on patients having Urban Worker Medical Insurance from twelve state-owned hospitals.Results The reform incurs a decrease in the outpatient and inpatient expenditure on medicine per visit (30％ and 21％,respectively),a decline in hospital's pharmaceutical ratio (9 percentages and 4 percentages,respectively); reduces the outpatient and inpatient expenditure per visit (19 ％ and 8 ％,respectively),with a decrease in the out-of-pocket part (23％ and 3％,respectively),and a slight increase in the Medical Insurance's part (2％); raises hospital's turnover (11％),outpatient's visits (22％),and inpatient visits (43％).Conclusion The reform encourages physicians to prescribe more scientifically,and hence reduces patient 's expenditure on medicine and hospital's pharmaceutical ratio; leads to a decrease in patience' s expenditure per visit;raises hospital's turnover; and doesn't cause a significant increase in the expenditure from social medical insurance.
