作　　者： (徐凤）; (金音子）; (孟庆跃）;

机构地区： 北京大学公共卫生学院,北京100191 北京大学中国卫生发展研究中心,北京100191

出　　处： 《中国卫生经济》 2017年第9期73-75,共3页

摘　　要： 目的:预测2016—2020年,全国三级和二级医院门诊和住院患者分流后能节省的直接医药费用。方法:使用直线趋势外推法,根据2006—2015年公立一级、二级、三级医院门诊人次数、入院人数、门诊病人次均诊疗费用、住院病人人均住院费用预测2016—2020年相应的人次数和费用。将不同机构病人的可分流比例分别取10%、20%、30%,计算分流后能够节省的直接医药费用。结果:若2016—2020年卫生服务利用趋势与2006—2020年一致,三级医院将保持门诊费用与患者人数的快速增长;若分别分流10%、20%、30%三级与二级医院的患者至二级和一级医疗机构,能节省费用总额的8%、16%、24%。结论:要控制医疗费用的增长,需引导患者合理就诊,加强二级医疗卫生机构能力建设,同时医疗卫生服务体系建设应适应分流比例。 Objective： To forecast the reduce of medical direct expenses of China from 2016 to 2020, under the circumstances that some outpatients and inpatients of tertiary hospitals and secondary hospitals could be distributed to primary medical institutions. Methods： According to the number of outpatients, number of inpatients, medical expenses of outpatients per visit, and medical ex- penses of inpatients per visit in the first grade, second grade and third grade public hospitals from 2006 to 2015, the corresponding visit numbers and costs from 2016 to 2020 were forecasted based on liner regression model. The percentages of transferable patients out of all patients in different levels of institutions could be equal to 10%, 20% and 30%. The direct medical expense could be saved ＇after the distribution were calculated. Results： If the trend of health service utilization from 2016 to 2020 were equal to the sample, the third grade hospitals would keep the fast increasing of outpatient expenses and patients. 8%, 16% and 24% of the total expenses would be saved if 10%, 20% and 30% patients in third and second were led to the second and first grade medical institutions. Con- clusion： It needed to slowdown the increasing trend of medical expenses, lead patients visit hospitals reasonably, strengthen the con- struction capacity of second grade medical and heahh institutions, meanwhile, the medical and health service system construction should adjust the distribution ratio.

关 键 词： 医疗卫生机构 患者分流 直接医药费用 费用节省 预测