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目的比较公立医院胃癌根治术的直接成本与定价的差距,分析定价的合理性。方法采用典型抽样方法,分别选取上海市、浙江省、湖北省和陕西省各一家三级医院作为样本医院,根据计算的胃癌根治术项目直接成本和手术收费标准,测算每例胃癌根治术的收费价格水平(收费标准/直接成本),并加以分析。结果在上海市、浙江省、湖北省和陕西省的样本医院中,平均每例手术的直接成本分别为2 628.96、3 078.79、3 634.17和1 839.49元;手术收费标准分别为1 860、1 860、2 000和1 880元。上海市、浙江省和湖北省样本医院的收费价格水平均<1(0.71、0.60和0.55),陕西省为1.02。结论各地区公立医院胃癌根治术的直接成本有较大差异,政府定价基本上均低于直接成本。适度调整医疗服务价格是扭转当前不合理的医疗成本补偿机制的有效途径。
Objective To compare the difference between direct cost and pricing in radical gastrectomy for public hospital and analyze the rationality of pricing. Methods A typical sampling method was used to select a tertiary hospital in Shanghai, Zhejiang, Hubei and Shaanxi Province as a sample hospital. According to the calculated direct costs and operating charges for radical operation of gastric cancer, the cost of each radical operation for gastric cancer was calculated Price level (fees / direct costs), and analyzed. Results In the sample hospitals in Shanghai, Zhejiang, Hubei and Shaanxi Provinces, the average direct costs per operation were 2 628.96, 3078.79, 3634.17 and 1839.49 yuan respectively. The operating charges were 1860 and 1860 , 2,000 and 1,880 yuan. Shanghai, Zhejiang Province and Hubei Province, the sample hospital fee levels <1 (0.71,0.60 and 0.55), Shaanxi Province was 1.02. Conclusion The direct costs of radical gastrectomy in public hospitals in all regions are quite different. The government pricing is basically lower than the direct cost. The proper adjustment of medical service price is an effective way to reverse the current unreasonable medical cost compensation mechanism.