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目的分析不同地区和级别医院静脉输液成本与政府定价的关系。方法采用典型抽样方法,分别选取上海市及浙江、湖北和陕西省的二、三级公立医院各一家,收集2007年的相关数据资料。调查各样本医院的静脉输液收费标准,测算人力和材料成本及收费价格水平,结合地区经济水平及各样本医院基本情况和经济运营状况进行综合分析。结果各样本医院的收费水平与当地经济发展水平相适应。静脉输液人力成本占总成本的比例,二级样本医院为72.36%～87.87%,三级样本医院为83.72%～94.46%;静脉输液收费价格水平,二级样本为0.12～0.85,三级医院为0.07～0.57;其中上海市和浙江省成本与定价的差距更为悬殊。各样本医院的人力成本回收率均小于<100%。结论静脉输液消耗的主要是人力成本。各地区医院静脉输液的实际成本均高于现行收费标准,护理人员的技术劳务价值未得到充分体现。应合理调整现行收费结构,并建立动态的医疗服务成本价格监测体系适时调整医疗服务价格。
Objective To analyze the relationship between the cost of intravenous infusion and government pricing in different regions and levels of hospitals. Methods A typical sampling method was used to select one of the second and third level public hospitals in Shanghai, Zhejiang, Hubei and Shaanxi Provinces respectively, and the relevant data of 2007 were collected. Investigate the sample hospital venous infusion charges, calculate the manpower and material costs and charges price level, combined with the regional economic level and the basic situation of the sample hospital and the economic operation of a comprehensive analysis. Results The sample hospitals’ charges are in line with the local economic development level. The proportion of intravenous transfusion manpower costs in total cost was 72.36% ~ 87.87% in secondary sample hospitals and 83.72% ~ 94.46% in tertiary sample hospitals. The price of intravenous infusion charges was 0.12-0.85 for secondary sample, 0.07 ~ 0.57; among them, the gap between cost and pricing in Shanghai and Zhejiang is more disparities. The labor cost recovery rate of all sample hospitals was less than <100%. Conclusion The main cost of intravenous infusion of labor costs. The actual cost of intravenous infusion in hospitals in all regions was higher than the current charging standard, and the value of technical labor for nursing staff was not fully reflected. The current charging structure should be reasonably adjusted and a dynamic monitoring system for the cost of medical services should be established to timely adjust the prices of medical services.