北京医药分开试点成效及启示--以北京朝阳医院为例

摘要

This paper aims at evaluating the effectiveness of the “Medical and Pharmaceutical Separation” re-form in Beijing in three years , and put forward suggestions for the reform of public hospitals .Using data obtained from hospital database, we compared changes in the proportion of drug cost , the average drug expenditures per time, medical workload , quality , income and structure .The key findings of this study show that after the reform , the quali-ty of medical services has improved .Compared to one year before the reform , in the third year of reform the outpa-tient and inpatient medicine accounted for decreased to 16.98%and 13.3%, from 25.57%and 36%, respectively;and the outpatient and inpatient patients per capita medical expenses decreased by 21.39%and 34.8%respectively. The health care revenue increased by 68 .1%compared with before reform .Drug revenue fell 14.29%before the re-form.Medical service fee income reached 243,500,000 yuan.Income from medical examination and laboratory tests in-creased by 52.60%.Based on the findings of the present investigation , the Trial“Medical and Pharmaceutical Separa-tion” to control the cost of drugs achieved good results .Therefore ,it would be advantageous in adopting the reform of public hospitals in the next step toward the medical examination separated , adjust the price of medical services ,etc.%目的：以北京市朝阳医院为例，分析北京市医药分开改革试点三年来所取得的成效，为公立医院改革提出建议。方法：收集医药分开试点前后门诊和住院的相关数据，对药占比、次均药费、业务量、医疗质量、收入及结构进行比较分析。结果：改革第三年与改革前一年相比，门诊、住院药占比分别下降16．98个百分点和13．3个百分点，年均降幅分别为25．57％和36％；门诊、住院患者次均／例均药费分别下降21．39％和34．8％。医疗收入较改革前增加68．1％；药品收入较改革前下降14．29％。医事服务费收入达到24350万元。检查、化验收入增加52．60％。讨论：试点医院医药分开对于控制药品费用效果良好。建议：公立医院改革下一步应朝着“医检分开”、调整医疗服务价格等方向推进。