目的 分析四川省公立医院2016年底取消药品加成与医疗服务项目价格调整政策对公立医院住院费用的影响,为进一步开展医疗服务价格改革提供依据.方法 以四川省某省属三甲公立医院在价格改革政策实施前后的住院费用数据为研究对象,比较各类费用的变化情况,对政策实施效果进行分析.结果 无论是全院整体,还是手术科室、非手术科室,出院患者人均药品费在方案实施后均降低,人均手术费、麻醉费在方案实施后均上升,且变化比例与政策调整幅度基本一致;无论是全院整体,还是手术科室、非手术科室,药占比、床位费占比在方案实施后均降低,但药占比在构成比中仍排位第一.结论 取消药品加成医疗服务价格调整对住院费用影响明显;医疗服务价格调整体现了医护人员技术价值.%Objective To provide advice and basis for further reform of the medical service price by analyzing the effect on hospital expenses after calling off drug-addition and price adjustment of medical service in public hospitals at the end of 2016. Methods Comparing the changes of hospital expenses based on the data of hospital expenses before and after the implementation of the price reform policy in a provincial public hospital in Sichuan. Results After canceling the drug-addition and adjustment of medical service price, whether in the whole hospital, in the surgical department or in the non-operative department, the average cost of drugs for discharged patients has been reduced, the average costs of surgical operation and anesthesia has been increased, the ratio of change remains consistent with the policy adjustment range, the composition of drug charges and bed fee has been decreased and the proportion of drugs still ranks first in the composition ratio. Conclusion Canceling the drug-addition and price adjustment of medical service have a significant effect on hospital expenses. The adjustment of medical service price reflects the technical value of medical staff.
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