北京市外来就医与购药对卫生总费用核算平衡的影响

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1、ChineseJournalofHealthPolicy，January2014，Vo1．7No．1·卫生筹资·北京市外来就医与购药对卫生总费用核算平衡的影响满晓玮张倩蒋艳赵丽颖周宇琼程薇1．北京中医药大学北京1O0o292．北京大学口腔医院北京100081【摘要】目的：揭示外来就医与外来购药费用对北京市卫生总费用核算平衡的影响程度。方法：外来就医数据以北京市卫生局公共卫生信息中心年报和部分医院内部信息化统计结果为主，外来购药费用的收集采用抽样调查的方法。结果：2011年，北京市外来就医、购药费用313．60亿元，占卫生总费用来源法与机构法核算结果总差异的77．23％。来源法大于机构法核

2、算结果且差异较大的黑龙江和吉林两省居民均在北京有较大比例的就医或购药行为。结论：北京市医疗系统承担了大量外地来京患者的医疗服务；药品零售机构药品销售费用中包含较高比例的外来消费，名优企业贡献突出；外来就医与外来购药是影响卫生总费用核算平衡的主要原因。建议：北京市卫生资源配置要充分考虑外来就医和购药因素；增加中央转移支付，缩小地区医疗资源差距；对外来就医、购药的研究应充分利用现有数据，并适当结合现场调查。【关键词】卫生总费用；核算；外来就医费用中图分类号：R197文献标识码：Adoi：10．3969／j．issn．1674-2982．2014．01．015Impactofnon—resid

3、ents’healthspendingontheregionalhealthexpenditureofBeijingMANXiao—weii，ZHANGQian，JIANGYanl，ZHAOLi-ngi，zHoUYu—qiongl，CHENGWeil1．BengUniversityofChineseMedicine，Be谫ng100029，China2．PekingUniversityStomatologicalHospital，Beijing100081，China【Abstract】Objective：Toanalysetheimpactofnon—residents’healths

4、pendingontheregionalhealthexpendi—tureofBeijing．Method：StatisticaldatafromBeijingMunicipalHealthBureauandsamplehospitalswasusedtocal-culatethehealthspendingofnon—residentsinBeijing．Asamplesurveyinretailpharmaciesprovidedthedatawhichcouldbeusedtomeasuremedicinesspendingofnon—residents．Result：Thehe

5、althspendingofnon-residentsinBei—jingisRMB31．36billionperyear，whichaccountsfor77．23％ofthedifferencebetweentheregionalhealthexpend-iturebythesourceandbytheproviderinBeijing．Forexample，healthspendinginBeijingofresidentscomingfromHeilongjiangandJilinprovinceswasconsiderable．Conclusion：Thehealthsyste

6、mofBeijinghasprovidedalargea—mountofhealthservicestonon—residentsfromotherprovinces．Salesinretailpharmaciesalsoincludesconsiderablemedicinesspendingofnon—residents．Non—residenthealthspendingisthemainreasonforthedifferencebetweenhealthexpenditurebythesourceandbytheproviderinBeijing．Suggestion：Heal

7、thspendingofnon—residentsshouldbeconsideredasanimportantcompositionoftheregionalhealthexpenditurewhenmakingpolicyofhealthresourceallocationinBeijing．Thecentralgovernmentoughttoincreasefinancetransferpaymentstoreducedis