新医药价格综合改革对中医院收入结构的影响分析

时孝春++胡青++钱爱兵

摘要：目的 了解新医改中价格改革对中医院收入结构的影响，对新医改实践初期的政策效果进行探讨。方法 选取江苏省74家中医院的基本信息及2014-2015年财务收支和业务运营数据作为研究样本，比较新医改政策实施前后医院收入结构的变化。结果 新医改政策实施后，政府对中医院的财政补贴增加；门诊收入中药品收入和检查费增幅较小，而诊察费涨幅最大达34.66%；住院收入中护理费上涨较快，达21.17%，而手术费和药品收入增幅较小，住院的药品收入与患者住院天数和中医院的级别呈负相关；县级中医院仍未摆脱原有的以药品和检查费收入为主的补偿方式。结论 政府需进一步加大对基层中医院的财政补贴力度，加强对基层中医院的人才、设备、技术扶持。

关键词：新医改；财政补贴；门诊收入；住院收入

DOI：10.3969/j.issn.1005-5304.2016.12.004

中图分类号：R2-05；R191 文献标识码：A 文章编号：1005-5304（2016）12-0014-04

Analysis on the Influence of New Medicine Price Comprehensive Reform on Income Structure of Traditional Chinese Medicine Hospitals SHI Xiao-chun1， HU Qing2， QIAN Ai-bing2 （1. Jiangsu Province Hospital of Traditional Chinese Medicine， Nanjing 210029， China； 2. School of Health Economic Management， Nanjing University of Chinese Medicine， Nanjing 210029， China）

Abstract： Objective To investigate the influence of price reform on income structure of TCM hospitals in new medical reform. Methods In this article， 74 TCM hospitals in Jiangsu Province were selected as research samples. Through the comparison of the hospital income structure of medical service supply before and after the new medical reform， the policy effect on the early practice of new medical reform was explored. Results After the implementation of the new health care reform policy， the government increased financial assistance to TCM hospitals； the increase of hospital medicine revenue and examination fee was not obvious， but diagnosis fee increased to 34.66%； hospitalized nursing fee increased rapidly to 21.17%， while the increase of operation fee and medicine revenue was not obvious. Hospital medicine revenue and the days of patients in hospital were in a negative correlation with the level of TCM hospitals. County TCM hospitals were still in the compensation ways of medicine and examination fee. Conclusion This requires the government to further strengthen financial assistance to the grassroots TCM hospitals， and increase personnel， equipment and technical support.

Key words： new medical reform； financial assistance； outpatient revenue； inpatient income

2015年，国务院办公厅印发《深化医药卫生体制改革2014年工作总结和2015年重点工作任务》，提出医药卫生体制改革（以下简称“医改”）的7个方面和27项重点工作任务。其中着重强调要“破除以药补医机制，推动建立科学补偿机制，进一步理顺医疗服务价格”[1]。由此可见，新医改是通过补偿机制的调整，改变医院传统以药费、检查费为主的收入结构，促使医院提高医疗服务的效率，通过医疗服务高

基金项目：国家中医药管理局资助项目[ZYYP-2014（1）]

通讯作者：胡青，E-mail：hqnjucm@163.com

效、优质供给，补偿医院在药品收入的缺口，避免医生开大处方、过度检查的行为激励导致医疗费用不合理增长。……