【作者】 陈煜；

【导师】 刘金宝；

【作者基本信息】 新疆医科大学 ， 社会医学与卫生事业管理， 2008， 硕士

【摘要】 目的:本课题通过对公众普遍关注的医疗费用居高不下问题和对新的医疗服务价格政策实施后的效果评估情况进行调查研究,了解掌握目前影响新疆医疗服务价格形成的主要因素,分析探讨当前医疗服务价格中存在的主要问题,以及导致问题的主要原因,旨在为我区的医疗服务价格进一步深化改革提供科学依据。研究对象与方法:以新疆地区10所综合性医院为研究对象,采用回顾性调查和现状调查的方法对被调查医院的收支状况、医患双方满意度进行整理分析。具体分析方法主要有视觉模拟评分法(VAS)、模糊综合评价法,Logistic回归等。结果:价格改革前后医院收入均呈现出总量变化不大但收入结构变化较大的趋势,劳务费用的大幅上升不仅填补了药品收入下降给医院收入带来的损失,而且带动了医院收入的进一步增长,导致医院收入总量呈现不降反升的状况;二、三级医院价格改革前后同期业务收入比较显示政策对三级医院影响较大;医院同期门诊收入和住院收入前后比较分析显示门诊药品收入比住院药品收入的构成比下降更为明显,而进行打包收费后的住院手术费出现了较大幅度的增长;医院问卷调查的结果显示,价格改革后医务人员更为关注的是门诊收入和住院收入,而患者更为关注的是名目繁多的检查项目和高额的自费药品价格。结论:1)我区自2005年实施新的医疗服务价格以来,扭转了过去变相的主收入渠道,理顺了医院的经营补偿机制,使医院的主要业务收入从药品倒向劳务,体现出尊重医务人员的劳务价值,提高了劳务付出的补偿;2)医院的总收入保持了基本稳定,科室之间收入结构得到了调整,大型设备、检验检查费用、材料加价的下调使医疗服务收费更加科学地符合价值规律;3)政策相对人的总体满意度尚可,收费结构有待进一步调整;4)拓宽宣传渠道,建立健全医疗机构内部费用控制长效机制,加大监督力度,以充分发挥价改政策的积极作用。更多还原

【Abstract】 Objective: This topic through analysis public universal attention’s medical expense question, in order to appraisal the new medical service price policy effect after 2004, analysis the primary factors affected the Xinjiang medical service price structure and research the subject matter which existed in the current medical service price, as well as the primary causes which caused the question. Methods: Take the Xinjiang area 10 General hospital as the object, uses the review investigation and the present situation investigation method to analysis the hospitals’revenue?expenditure condition and the medical personnel?the patient both sides degree of satisfaction. The study method is visual analogue scals(VAS), the Logistic regression and so on. Results: After the price adjustment, the total hospital income is quantity change but the income structural has big change, service cost’s large rise not only filled the the loss of drug income’s drop but also led the hospital income further growth, causes the hospital income total quantity does not fall instead rises; Compare with two level of hospital, policy is big influences to three level of hospital in the same time; Compare the outpatient service income and in hospital income ,the outpatient service drugs income’s drop is more obvious than in hospital drugs revenue, but operation fee presented the great scope growth after carrying on the pack charge in hospital; The hospital questionnaire survey’s result showed that after price adjustment, what the medical personnel more pay attention to the outpatient service income and in hospital income, what but the patient is more pays attention to the inspection and the drugs expense. Conclusions: 1) The new medical service price has implemented in xinjing since 2005, reversed the past main income channel in disguised form, straightened out the hospital management compensation mechanism, causes the hospital the primary business income from the drugs reverse service, manifests the respect medical personnel’s service value, enhances compensation which the service pays. 2) The hospital gross income maintained basic stable, between the administrative offices the income structure obtained the adjustment, the large-scale equipment, the examination inspection expense, the material increase price the decline causes the medical service charge to conform to the law of value scientifically. 3) Policy relative person’s overall degree of satisfaction still permissible, further tune-up inspection and the drugs income are imminent. 4) Increases the reform propaganda dynamics, establishes the perfect medical service supervising mechanism, solves the reform, after properly appears the derivation question, forms the Medical establishment interior expense control, the responsibility restraint driving mechanism to achieve the price reform policy truly the true effect.更多还原