医药分离改革对第三级公共医院住院费用的影响:基于北京小组数据的差异分析
Wenjuan Wang1, Juanjuan Liang1, Rong Fan2
1School of Government, Central University of Finance and Economics, Beijing, 100081, People's Republic of China.
Risk management and healthcare policy
|May 21, 2024
概括
医药分离 (MPS) 改革大大减少了北京医院的药品支出. 然而,它导致医疗消耗品成本增加,突出了需要更好的管理和综合支付系统的需求.
科学领域:
- 医疗保健经济学 医疗保健经济学
- 医疗保健服务研究 医疗服务研究
- 公共卫生政策 公共卫生政策
背景情况:
- 中国的医药分离 (MPS) 改革旨在通过降低药品支出来制医疗保健成本的上升.
- 三级公立医院在医疗保健提供和支出模式中发挥着至关重要的作用.
研究的目的:
- 评估MPS改革对住院费用的影响及其在北京三级公立医院的组成.
- 评估与诊断相关的群体 (DRG) 支付对改革有效性的影响.
主要方法:
- 使用倾向得分匹配和多期差异分析.
- 使用差异差异模型来检查DRG支付异质性.
- 分析了来自北京18家三级公立医院的月度面板数据 (2011年7月至2017年3月).
主要成果:
- 医疗保健改革导致每次住院平均药物开支大幅下降 (所有药物的平均开支为24.5%,西方药物的平均开支为24.6%,中国药物的平均开支为24.1%).
- 药品支出占比下降了4.5%,而医疗消耗品支出占比增加了2.7%.
- 医疗消耗品支付缓解了医疗消耗品支出的上升.
结论:
- 医疗保健改革有效优化了住院费用结构,控制了不合理的成本上.
- 将DRG支付与MPS改革整合,提高了其在控制支出方面的有效性,特别是在医疗消耗品方面.
- 加强医疗耗材管理和促进MPS改革与DRG支付之间的联系对于长期成功至关重要.
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