Analyze the Outpatient Cost Structure Change after the Comprehensive Reform of Public Hospitals by the Least Squares Trend Seasonal Multiplication Model

摘要

Background: To find out the seasonal variation rule of outpatient expenditure structure from 2013 to 2016, and predict the outpatient cost structure change in 2017 by the least squares trend seasonal multiplication model, and analyze the effect after the comprehensive reform of public hospitals. Methods: Collect the outpatient cost data from 2013 to 2016. The least squares method was applied to calculate the monthly seasonal ratio, and to fit the linear trend equation. Then the trend was rejected, checking and the final trend prediction was carried out, and the interval prediction was carried out with a confidence level of 95%. Results: The actual average medicine cost of outpatient in 2017 began to lower than left interval value of the forecast range from July. Inspection fees and test fees also tend to within the scope of the predicted values. However, the diagnosis and examination fees, operation fees, bed fees, Chinese herbal medicine fee is higher than the right interval value of the predicted values. Conclusion: By comparing the predicted values of 2017 outpatient cost structure and the actual production, we found that in accordance with the comprehensive reform of public hospitals structural price adjustment, the cost of medicine, inspection fees and inspection fees were reduced, the costs of diagnosis, surgery, nursing, traditional Chinese medical that can reflect personnel technical services value have increased. The comprehensive reform of public hospitals has significant effect. As a result of the drug addiction policy, the problem of "relying on drugs to support doctors" is becoming more and more serious. The hospitals and doctors can get the benefit by prescribing the prescription, giving the patients a lot of drugs, and letting the patients use expensive medicine. This practice not only aggravates the economic burden for patients, but also brings hidden trouble to the public health, resulting in the problems of drug safety. Comments on the deepening of the reform of the medical and health system by the Central Committee of the Communist Party of China (2009) (No.6) (hereinafter referred to as "the new medical reform opinion"), the recent key implementation scheme of the medical and health system reform (2009-2011) (No. 12) (hereinafter referred to as the "implementation scheme"). They are all aimed at changing the problems of "relying on drugs to support doctors". The new medical reform opinion and implementation scheme will be the key for deepening the reform of the medical and health system, including basic medical security, basic drug system implementation, basic medical and health system construction, public health equalization and public hospital reform. Among them, the reform of public hospitals is the difficulty of new health care reform, and the focus of public hospital reform is a chronic disease of "relying on drugs to support doctors".