陈莉,李栋栋,王蕾,邵新春,王士然,王帅,杨敬源
CHEN Li,LI Dongdong,WANG Lei,SHAO Xinchun,WANG Shiran,WANG Shuai,YANG Jingyuan

• 1:贵州医科大学公共卫生学院
• 2:贵州省卫生计生委
• 3:贵州省人口和计划生育科学研究技术指导所
• 4:浙江极地新城健康管理有限公司

摘要(Abstract)：

目的:分析遵义市城市公立医院医改效果及存在问题,为进一步合理规划城市公立医院医疗改革提供参考。方法:利用国家卫生计生统计信息网络直报系统中医改监测数据,对遵义市16家城市公立医院的基本收入、医药费用、资产负债、床位、医疗设备、人力资源及医疗服务利用等情况进行分析。结果:2010年以来遵义市城市公立医院的总收入、财政补助、科教及医疗各项收入均逐年上升,药品收入占医疗收入的比重及住院药费占人均住院费用的比重均逐年下降,总资产、负债总额及资产负债率均逐年增加,自2013年资产负债率超过50%;编制床位数增幅逐年提高,而实有床位数增幅在2015年出现降低,且低于编制床位数;万元以上设备台数和总价值均逐年增加、且万元以上设备总价值增幅高于万元以上设备台数增幅;在岗职工数逐年增加,自2014年超过了编制人数,2010-2016年,医护比均高于1∶1.25;门急诊人次数、入院人数、出院人数及医师日均担负诊疗人次均逐年上升,病床工作日、病床使用率及出院者平均住院日均呈下降趋势,自2014年病床使用率低于100%。结论:遵义市城市公立医院改革虽已取得明显进展,但仍面临许多问题,应结合改革中出现的问题和实际情况,进一步完善城市公立医院改革发展规划。
Objective: To analyze the effect and problems of medical reform in urban public hospitals in Zunyi,so as to provide references for further rational planning of medical reform. Methods: The basic income,medical expenses,asset liability,beds,medical equipment,human resources and medical service utilization of 16 urban public hospitals in Zunyi were analyzed on the healthcare reform monitoring data of the National Health Planning Statistical Information Network Direct Reporting System.Results: Since 2010,the total income,financial aid,science and education,medical income of the public hospitals in Zunyi were increasing yearly. The proportion of drug income to medical income and the proportion of inpatient charge to the per capita cost of hospitalization declined yearly. The total assets,total liabilities and asset liability percentage increased yearly. Since 2013,the debt ratio was over 50%. The number of registered beds increased yearly,while the number of operational beds decreased in 2015,which was lower than the number of registered beds. The number of equipment worth over 10 000 yuan and the total value increased yearly,and the increase in total value of equipment worth over 10 000 yuan was higher than that of the number of equipment over 10 000 yuan. The number of full-time employees increased yearly,and exceeded the number of authorized workers since2014. The ratio of doctor and nurse was higher than 1∶ 1. 25 from 2010 to 2016. The number of outpatient and emergency patients,the number of inpatients,the number of discharged patients,and the daily average number of patients diagnosed by doctors increased yearly. Beds working day,beds utilization ratio and average hospitalization length all showed decreasing trend,and the utilization ratio of beds was less than 100% since 2014. Conclusion: Although the reform of public hospitals in Zunyi had made significant progress,there were still many problems. Existing problems and practical conditions should be fully considered to further improve the reform and development plan of urban public hospitals.

关键词(KeyWords)： 公立医院;收入;医药费用;医院资产;人员
public hospital;income;medical expenses;hospital assets;personnel

Abstract:

Keywords:

基金项目(Foundation): 贵州省卫生计生委基金项目(gzwjkj2014-1-013)

作者(Author): 陈莉,李栋栋,王蕾,邵新春,王士然,王帅,杨敬源
CHEN Li,LI Dongdong,WANG Lei,SHAO Xinchun,WANG Shiran,WANG Shuai,YANG Jingyuan

DOI: 10.19367/j.cnki.1000-2707.2018.08.011

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