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目的:探讨盈亏平衡法在公立医院收支评价中的应用。方法:按照《医院财务制度》规定,计算公立医院业务量、成本、收支结余,建立收支平衡方程式,计算安全边际率、保利点,并以宁波市2003年～2007年29所不同类别的公立医院收支状况进行验证,考察安全边际率与公立医院收支评价综合指数间的相关性。结果:宁波市29所公立医院2003-2007年安全边际率最高的医院是C10医院,达34.67%;最低的医院是B9医院,只有-35.75%;安全边际率分布以10%～20%为主(占44.83%),30%以上的只有3.45%,与实际工作情况基本相符。安全边际率与收支综合评价综合指数U值的相关性分析表明,两者之间呈现出显著性正相关关系(r=0.302,P=0.000)。结论:本文提出的盈亏平衡法是一种实用、有效的公立医院收支监管方法,值得推广应用,并认为各级政府应按照“公共医疗卫生”的要求,增加政府投入,建立科学、规范的公立医院财政补偿制度。
Objective: To explore the application of break-even method in the evaluation of public hospital revenue and expenditure. Methods: According to the “hospital financial system” regulations, public hospital business volume, cost, income and expenditure balance, the establishment of the balance of payments equation, calculate the margin of safety margin, Paul points, and in Ningbo from 2003 to 2007 in 29 different categories Public hospital revenue and expenditure to verify the status of security marginal rate and public hospital revenue and expenditure evaluation of the correlation between the composite index. Results: The hospitals with the highest safety margins in 29 public hospitals in Ningbo City from 2003 to 2007 were C10 hospitals, accounting for 34.67%; the lowest hospitals were B9 hospitals with only -35.75%; and the marginal rates of safety were 10% to 20% (Accounting for 44.83%), only 3.45% over 30%, basically in line with the actual work. The analysis of the correlation between the safety marginal rate and the composite index of comprehensive evaluation of income and expenditure shows that there is a significant positive correlation between the two (r = 0.302, P = 0.000). Conclusion: The breakeven method proposed in this paper is a practical and effective public hospital revenue and expenditure monitoring method, which is worthy of popularization and application. It is also believed that governments at all levels should increase government investment and establish a scientific, Standard public hospital financial compensation system.