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目的探讨控制住院医疗费用过度增长的途径。方法对成都市1993年至2005年住院医疗费用变动情况进行时间序列分析。结果(1)1993年-2005年12年间住院医疗费用由人均1395元增至5632元,定基比403．73％。药费由630元增至2201元,定基比349．37％;其他费用由765元增至3431元,定基比448．50％。相对而言,其他费用的增长幅度大于药费的增长幅度。(2)在住院医疗费用不断增长的同时,住院治疗病人数由49．72万人次增至106．38万人次,定基比213．96％。(3)药品费比例逐年下降,由1993年为45．16％,2005年下降至39．08％。(4)2001年的医改使得住院人数以及住院医疗费的增长幅度一度下降或变缓。结论在控制医疗费用过度增长时,既应控制药品费用的比例,也应防止为达到降低药品费用比例的目的,而增加不合理检查治疗项目的过度医疗现象的发生;同时要妥善解决好“举证倒置”、“执行诊疗规范与控制医疗费用、有效降低患者住院医疗负担的关系。
Objective To explore ways to control the excessive growth of hospitalization expenses. Methods The time series analysis of the change of hospitalization expenses in Chengdu from 1993 to 2005 was conducted. Results (1) From 1993 to 2005, the cost of hospitalization increased from 1,395 yuan to 5,632 yuan per capita for 12 years, with a fixed base ratio of 403.73%. Drugs increased from 630 yuan to 2201 yuan, set base than 349.37%; other costs increased from 765 yuan to 3431 yuan, set the base ratio of 448.50%. Relatively speaking, the growth rate of other expenses is greater than the increase rate of drug fees. (2) As the cost of hospitalization increased, the number of hospitalized patients increased from 497,200 to 1,063,800 and the base rate was 213.96%. (3) The proportion of drug fees decreased year by year, from 45.16% in 1993 to 39.08% in 2005. (4) The medical reform in 2001 caused the number of hospitalizations and hospitalization expenses to decrease or slow down once and for all. Conclusion In controlling over-growth of medical expenses, we should not only control the proportion of drug costs, but also prevent over-medical phenomenon of unreasonable examination of treatment items in order to achieve the purpose of reducing the proportion of drug costs. At the same time, Inverted, “” the implementation of medical treatment norms and control of medical costs, effectively reduce the burden of hospitalized patients in the relationship. "