北京市医药分开综合改革对三级综合医院运行的影响——以R医院为例

摘要

Objective:To empirically evaluate the impact of the reform of separating drug sales from medical services reform on the operation of public hospitals in Beijing. Methods:Taking R hospital as a case study,Twenty-six clinical departments were selected as samples, and the indicators which have significant change after medical reform were analyzed by descriptive statistics,Pairing test,Correlation test and Spearman correlation test. 24 tested indicators included workload,cost and medication behavior. Results:After the Beijing medical reform between May to September 2017,and from May to September 2016, R hospital workload and cost indicators changed in varying degrees. There were differences between the two groups in terms of the internal medicine and surgery,and the medi-cation behavior had no significant change. Conclusion:The effect of Beijing's healthcare reform policy is obvious. R hospital has the trend of decreasing outpatient volume, drug proportion and medical insurance costs. The medical reform policy may have a profound impact on the development of the clinical subject.%目的:分析北京市医药分开综合改革对公立综合医院运行的影响.方法:以R医院为例,选取26个临床科室作为样本,对工作量、费用、用药行为等指标做描述统计,并对跨期变化率做配对T检验或秩和检验以及进一步的Spearman相关性检验,分析医改政策对医院运行指标影响的显著性.结果:2017年5—9月北京医改后同比2016年5—9月,R医院工作量和费用指标出现不同程度变化,内外科受影响存在差异,用药行为无显著变化.结论:北京医改政策效果明显,R医院门诊量、药占比、医保费用出现下降的趋势;医改政策可能会对临床学科发展产生深远影响.