目的：评估某院实行医药分开为主导的改革近2年的效果。方法分别选取某院医药分开改革前1年、医药分开后第1年、第2年费用构成、服务量、效率等监测指标，采用自身同期对照，分析医药分开改革成效。结果医药分开改革后的2年较改革前的1年，门诊医保患者次均费用分别降低12.03%和5.7%，住院医保患者次均费用分别降低4.08%和2.69%，医保患者的药品费用也明显下降；门诊服务量有所减少，而医保患者稳步增加；号源分布呈明显分化和学科差异；门诊医事服务费略有盈余，住院医事服务费略有亏欠，总体收入结构基本实现从药品加成到医事服务费的平移转换；医院运行效率稳步提升。结论医药分开改革减轻了患者负担，引导患者合理就医，促使医院加强内部精细化管理，积极进行结构调整，最终使患者获益。%Objective To evaluate the outcomes of this reform to the hospital in the past two years.Methods Collecting such indexes as expenses composition,service volume and efficiency of the year before,the first year and the second year of the reform made at the hospital.Comparing the statistics and analyzing the effectiveness.Results Average outpatient expenses per visit and outpatient drug costs of patients with medical insurance during the two years of reform were found to be 12.03% and 5.7%respectively lower than the year before;while the average expenses per case fell by 4.08% and 2.69%respectively,with drug costs falling significantly as well.Outpatient visits fell,with steady increase of outpatients with medical insurance coverage.The distribution of outpatient visits varies significantly in terms of medical branches.There are a slight surplus of medical service charges of outpatients,and slight deficit of medical service charge of inpatients,with a smooth shift of the income makeup from dependence on drug price markup to medical service charge,and steady improvement of hospital efficiency.Conclusion The reform can alleviate patients’financial burden,encourage rational visits of doctors,promote fine management and structure adjustment,benefiting patients in the end.
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