| 引用本文：周忠良,苏延芳,周志英,等.基本药物“零差率”政策对住院费用的影响——基于陕西省县级公立医院的研究[J].中国卫生政策研究,2013,6(12):25-32 |
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| 基本药物“零差率”政策对住院费用的影响——基于陕西省县级公立医院的研究 |
| 投稿时间：2013-10-16 修订日期：2013-11-18 PDF全文浏览 HTML全文浏览 |
| 周忠良1, 苏延芳2, 周志英1, 高建民1, 禹强3, 陈玖浩4, 潘益山5 |
1. 西安交通大学公共政策管理学院卫生管理与政策研究所 陕西西安 710061
2. 哈佛大学公共卫生学院 美国波士顿 02115
3. 陕西省安康市发展和改革委员会 陕西安康 725000
4. 陕西省宁陕县人民医院 陕西宁陕 711600
5. 陕西省镇坪县人民医院 陕西镇坪 725600 |
| 摘要:目的：分析县级公立医院基本药物“零差率”政策对次均住院费用及其药品费用的影响。方法：采用有对照的前后比较设计，数据来源于实施基本药物“零差率”的宁陕县人民医院（干预组）和未实施基本药物“零差率”的镇坪县人民医院（对照组），包括医院统计报表资料和住院病历资料；采用倍差法进行分析。结果：基本药物“零差率”政策的实施使县级公立医院的次均住院费用和次均住院药品费用分别降低了389.11元和278.42元，药品费用占住院费用的比例降低了3.9个百分点；对于病例数较多的五种常见住院病种来说，基本药物“零差率”政策仅仅对于部分病种的医疗费用有显著影响。结论：在宁陕县人民医院实施的基本药物“零差率”政策减轻了病人的住院负担，但是受益面因病种而存在差异。 |
| 关键词:县级公立医院 基本药物“零差率” 倍差法 次均住院费用 |
| 基金项目:陕西省社会科学基金项目（12Q036）；美国中华医学基金会种子基金；西安交通大学“新教师科研支持计划” |
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| The impact of zero-markup drug policy on inpatient expenditure：Evidence from county public hospital in Shaanxi Province |
| ZHOU Zhong-liang1, SU Yan-fang2, ZHOU Zhi-ying1, GAO Jian-min1, YU Qiang3, CHEN Jiu-hao4, PAN Yi-shan5 |
1. Center of Health Management and Policy，School of Public Policy and Administration, Xi'an Jiaotong University，Shannxi Xi'an 710061, China;
2. Havard School of Public Health, Boston MA 02115, USA;
3. Ankang Development and Reform Commission, Shannxi Province, Shannxi Ankang 725000, China;
4. People's Hospital of Ningshan County, Shannxi Province, Shannxi Ningshan 711600, China;
5. People's Hospital of Zhenping County, Shannxi Province, Shannxi Zhenping 725600, China |
| Abstract:Objective: This study aims to analyze the effect of zero-markup drug policy in the county public hospital on the per-visit inpatient expense and drug expense. Methods: The controlled before and after study design was employed in this study. Data came from hospital statistics and medical records in county-level people's hospitals. Ningshan County implemented the zero-markup drug policy (intervention group) and Zhenping County serves as control group in the study design. The analysis method of difference-in-difference was employed. Results: The zero-markup drug policy reduced the per-visit inpatient expense, per-visit drug expense and the proportion of drug expense in inpatient expense by 389.11 Yuan, 278.42 Yuan and 3.9 percent, respectively. For the top five most frequent conditions of inpatient services, the effect of zero-markup drug policy on inpatient expense is only significant for particular conditions. Conclusion: On average, the implementation of zero-markup drug policy in Ningshan county hospital reduced the financial burden for inpatient services. However, the impact of the policy varies by condition. |
| Key words:Public hospital Zero-markup drug policy Difference-in-difference Per-visit inpatient expense |
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