| Objective: In recent years,with the development of society and economy,and the upgrading of consumption structure in our country rapidly ageing population,disease model,combined with the basic medical and health system and constantly improve the level of medical technology continues to improve,people’s demand for medical services to be released,China’s medical and health undertakings entered the stage of rapid development,the rapid rise of medical expenses.The situation of medical expenses structure and growth also exist unreasonable factors,including city public hospital costs in the total medical expenses accounted for a larger amount of medical services especially the inpatient services grew rapidly,medicine,diagnosis and treatment of large medical equipment and medical supplies accounted for relatively high costs.At the same time,the size of the public hospitals,medical technology,scientific research level,to solve the difficult miscellaneous diseases continues to increase,the medical cost is increasing year by year.Based on the analysis of medical cost and cost trend of nearly five years of a public hospital through the investigation,analysis of the factors of change,prompting the government,hospitals,patients with three party balance of interests,trying to find a reasonable and effective measures,the medical cost and expenses of public hospitals to reach mutually reasonable level,which will solve the "doctor your problem,but also to ensure the steady development of the hospital.Methods: By consulting relevant literature,we collected the related research on medical costs and costs of public hospitals at home and abroad,and analyzed the current situation of medical costs and costs of public hospitals in China,combined with relevant documents and information issued by governments at all levels and public health administrative departments.Using the information system of a public hospital,the data of personnel,medicine,material expenditure,hospitalization expenses and outpatient expenses of a hospital were derived.The main data of medical costs and the cost of 2012-2016,statistical analysis is carried out by SPSS20.0,the average speed of development,the average growth rate of the cost of health care and medical expenditure,the structure change of hospital total cost,office cost,medical cost,average cost and the cost of single disease such as value(VSV)and the degree of structure variation(DSV),the structure analysis of contribution rate.Results: The hospital cost in 2012-2016 years structure is the largest contribution rate of average personnel expenditure is 26.75%,followed by health materials costs accounted for 26.91% and drug costs accounted for 23.42%;during the personnel expenditure growth rates were 18.08%,5.80%,21.16%,8.57%,health materials costs growth rate was 22.03%,15.04%,-0.18%,11.56%,drug cost growth rates were 6.96%,5.58%,4.79%,-9.31%,showed a decreasing trend;hospital costs accounted for the top three are drug expenses,personnel expenses and health materials costs,the average growth rate of the most prominent is the staff of 13.40%,followed by health materials costs 12.11%,the growth rate of only 2.01% of drug costs.In the analysis of the total cost structure of the Department,drug fees,personnel funds,health materials costs are still the top three items in the proportion of cost components.The medical expenses of a public hospital outpatient medical expenses during 2012-2016 years,the largest contribution rate of change is the treatment fee of 28.27%,followed by drug fee of 27.55%,the contribution rate of the minimum change registration fee is 1.72% and 2.49% for surgery;hospitalization expenses of contribution rate of change is the largest of 28.27% materials,followed by drug costs 18.31%,change the contribution rate is 1.49% and the minimum fee checkups fee of 3.30% beds.The average annual growth rate of outpatient expenditure was 5.37%,-7.58%,0.64% and 1.21%,respectively,and the annual hospitalization expenses increased by 7.26%,4.19%,-0.12% and-8.53%,respectively.From the medical expense single disease expense statistical data,each kind of disease each year average expense change tendency is quite stable.The relationship between medical costs and medical expenses in a public hospital was 5.26%,3.62%,2.85%,-2.45% and-2.28%,respectively,in 2012-2016 years.The number of outpatient costs relatively stable,while the corresponding number of outpatient costs increased,the cost income rate were 81.46%,84.45%,92.58%,97.43%,93.1%;hospitalization cost income ratio was 105%,106%,104%,110%,109%,that part of the cost is higher than the income of hospital.Negative balances occurred in hospitals in 2015 and 2016.Conclusions:In 2012-2016 years,the cost of traditional Chinese medicine,the cost of traditional Chinese medicine,the expenditure of personnel and the cost of medical materials were the top three,while the cost of personnel increased fastest.Medical expenses in the proportion of structural change,the registration fee disappeared,inspecting fee increased the proportion of drug costs decline in the proportion of drug costs;and material fees and test fees occupy the medical expense of the patients before three.The relationship between medical costs and medical costs in public hospitals is rising year by year,the medical cost rises year by year,the structure of medical income changes,and the cancellation of drug profits,the lack of government compensation,the decrease of business balance rate,and the unprecedented negative balance in the last two years.It is necessary for the government and the government to further deepen the reform of the medical and health system,improve and adjust the price policy of medical services,implement the government’s reasonable compensation,reform the payment mode of medical insurance,and improve the level of basic medical insurance.Public hospitals should strengthen budget management,cost accounting,operation cost reduction,cost reduction,efficiency improvement,medical quality improvement and patient satisfaction with medical treatment. |
