目的: 分析医疗服务价格改革与DRG付费改革的相互关系,探讨两者之间的共同作用,为政府决策和医院高质量发展提供参考。方法: 基于2018—2022年样本医院610624例住院患者结算清单数据,采用结构变动度和灰色关联分析法对医院住院费用的结构变动度、结构变动度贡献率及关联度情况进行定量分析。结果: 2018年以来,样本医院住院次均费用呈波动下降趋势,年均下降1.81%,其中药品费占比逐年下降,结构变动贡献率最高;治疗费、手术费相对上升,结构变动贡献率次之;但检验费、检查费占比相对上升,耗材费占比基本不变。结论: 医疗服务价格改革联合DRG付费改革促进了医院医疗费用结构的优化,应进一步提升两者共同作用,加强两者互补关系,不断优化医院收入结构,助力医院高质量发展。

Objective: The paper analyzes the relationship between medical service price reform and DRG payment reform, explore the synergistic mechanism between the two, and provide a reference for government decision-making and high-quality development of hospitals. Methods: Based on the data of 610624 patients from the sample hospitals from 2018 to 2022, the paper applied the degree of structural variation and grey relation analysis method to quantitatively analyze the degree of structural variation, the contribution rate of the degree of structural variation, and the correlation degree of hospitalization expenses. Results: Since 2018, average hospitalization expenses of the sample hospitals have shown a fluctuating downward trend, with an average annual decrease of 1.81%. Among them, the proportion of drug fees has been decreasing year by year, with the highest contribution rate to structural changes. The cost of treatment and surgery has relatively increased, and the contribution rate is inferior to drug fees. However, the proportion of laboratory fees and inspection fees has relatively increased, while the proportion of sanitary material fees remains basically unchanged. Conclusion: The medical service price reform and DRG payment reform promoted the optimization of the medical expense structure of hospitals. It is necessary to strengthen the synergy of the two, strengthen the complementary relationship, further optimize the revenue structure of hospitals, and promote high-quality development of hospitals.