目的 对比北京市医药分开综合改革前后医疗机构各项数质量指标变化,分析、查找原因,并对医疗机构建设发展提出意见和建议,对兄弟省市做好医药分开综合改革提供参考、借鉴.方法 对北京市辖区内参与改革的17家三甲医院进行调研分析,发现北京市医药分开综合改革对医疗机构造成的影响及变化,并分析原因.结果 医改后,三甲医院的门急诊量、收容量、药占比、人次均费用都不同程度地下降,涉及人力成本较高的治疗费、护理费呈现增长态势.结论 此次北京市医药分开综合改革基本实现分级诊疗,取消药品加成"改善医事服务、提高医疗质量、确保医疗安全"基本达到预期目标,医疗机构可以通过加强科学管理、规范医疗行为、提高服务质量、夯实安全基础等一系列措施,提增基础医疗质量,提高医事服务内涵,提升患者就医获得感.%Objective To compare the changes in the quality indicators of various medical institutions be-fore and after the comprehensive reform of the medical and pharmaceutical industries in Beijing, analyze the influ-encing factors, and provide suggestions for the construction and development of the medical institutions and refer-ence for the comprehensive reform of the medical and pharmaceutical industries in other provinces and cities. Methods By investigating and analyzing the 17 tertiary hospitals involved in the reform in Beijing, this paper identified the impact on the medical institutions caused by the comprehensive reform of the medical and pharmaceu-tical industries in Beijing and analyzed the reasons accordingly. Results After the reform, the volume, accommo-dation capacity, medicine proportion and average cost per capita of the outpatient and emergency departments all decreased to different degrees. Treatment fees and nursing care fees that involve higher manpower cost showed an increasing trend. Conclusion The comprehensive medical reform in Beijing has basically realized the system of hierarchical diagnosis and treatment and eliminated the outdated principle of " basing treatment on medicine" . Med-ical institutions can improve the quality of basic medical services, complement the content of medical services and promote patients'access to medical treatment by taking a series of measures, including strengthening scientific man-agement, standardizing medical conducts, improving service quality, and consolidating solid foundation for safety.
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