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目的:预测2016—2020年,全国三级和二级医院门诊和住院患者分流后能节省的直接医药费用。方法:使用直线趋势外推法,根据2006—2015年公立一级、二级、三级医院门诊人次数、入院人数、门诊病人次均诊疗费用、住院病人人均住院费用预测2016—2020年相应的人次数和费用。将不同机构病人的可分流比例分别取10%、20%、30%,计算分流后能够节省的直接医药费用。结果:若2016—2020年卫生服务利用趋势与2006—2020年一致,三级医院将保持门诊费用与患者人数的快速增长;若分别分流10%、20%、30%三级与二级医院的患者至二级和一级医疗机构,能节省费用总额的8%、16%、24%。结论:要控制医疗费用的增长,需引导患者合理就诊,加强二级医疗卫生机构能力建设,同时医疗卫生服务体系建设应适应分流比例。
OBJECTIVE: To predict the direct medical costs that will be saved after the diversion of outpatient and inpatient tertiary and secondary hospitals nationwide between 2016 and 2020. Methods: According to the linear trend extrapolation method, according to the number of outpatients, the number of hospital admissions, the average outpatient medical expenses and the inpatient per capita hospitalization costs of public primary, secondary and tertiary hospitals from 2006 to 2015, Number of people and costs. The diversion ratio of different institutional patients were taken 10%, 20%, 30%, calculate the direct medical costs savings after shunt. Results: If the trend of health service utilization in 2016-2020 is consistent with that of 2006-2020, tertiary hospitals will maintain the rapid growth of outpatient fees and patient numbers. If the distribution of tertiary and secondary hospitals by 10%, 20% and 30% respectively Patients to level 2 and level 1 medical institutions can save 8%, 16%, 24% of the total cost. Conclusion: In order to control the growth of medical expenses, it is necessary to guide patients to seek reasonable treatment and to strengthen the capacity building of secondary medical and health institutions. At the same time, the medical and health service system should be adapted to the proportion of diversion.