【作者】 朱星月； 邓毅； 胡明；

【Author】 Zhu Xingyue;Deng Yi;Hu Ming;

【机构】 四川大学华西药学院； 成都市妇女儿童中心医院药学部；

【摘要】 目的:基于成都市医疗保险数据,评估成都市第三次取消药品加成产生政策的实施效果。方法:使用成都市2012年1月至2017年10月城镇职工与城乡居民住院数据构建间断时间序列模型,分析政策实施对住院患者医疗负担及医疗费用结构的影响。结果:取消药品加成使城镇职工与城镇居民参保人群的次均住院药品费分别下降了489与341元,次均住院药占比分别下降1.7%与2.0%,两个指标的长期趋势上也出现下降;而护理费、手术费及等指标有不同程度上升,次均总费用、医保支付费用与患者自付费用未受政策影响。结论:通过取消药品加成改革,患者的住院医疗费用结构发生变化,药品费用下降而体现医务人员劳动价值的手术费、护理费上升,但患者医疗总负担仍不断增长。更多还原

【Abstract】 Object: To evaluate the effect of zero drug mark-up in Sichuan, Chengdu based on local medical insurance data. Method: Constructing interrupted time series models using inpatient cases of both Urban Employees and Urban and Rural Residents from Jan 2012 to Dec 2017, and analysising the policy impact on the medical burden and medical cost proportions. Result: Zero drug mark-up made 489 yuan and 341 yuan decrease of drug fee per capita in Urban Employees and Urban and Rural Residents respectively, and 1.7% and 2.0% cut down of drug fee proportion in the two basical medical insurances respectively, whereas policy made the nursing fee and surgical fee increase; total medical cost per capita, compensation cost per capita and out-of-pocket per capital were not influenced by the policy. Conclusion: Medical cost proportion changed after implementing zero drug mark-up, represented as decrease in drug fee and increase in nursing and surgical fees which could reflect the value of medical service providers, but medical burden was not relieved.更多还原