广州市公费医疗人群就医倾向及其医改后对医院的影响

目的：配合广州市医疗保障制度改革。分析公费医疗病人的就诊流向和医疗费用及其医改后对医院的影响。方法：发放调查表收集广州城区56家医院1995－1998年的公费病人就诊数量和医疗费用。结果：公费门诊“病人”快速增长，并有向高级别医院集中的趋势；公费住院病人增长较快，集体医院成倍增长；人均医疗费用得到一定程度的控制，门诊总费用增长快，住院总费用增长适度；门诊与住院人次的比率高于同期总体水平一倍有余。结论：公费医疗人群门诊消费过度，医改后公费门诊人次将大幅下降，导致医院6业务收入减少约4％－6％。

The Tendency of Seeking Medical Advice in Public Medical Care and Its Influence after Medical Reform

Objective To analyze the patient flow tendency of seeking medical advice in public medical care and its influence on hospital after the medical guarantee system reform. Methods The data of patient number and medical expenses in 56 hospitals from 1995 to 1998 were collected through questionnaire. Results The number of outpatient of public medical care grew up rapidly and the tendency to higher-rank hospital was showed. The inpatient went up fast. The collective hospitals raised by several times. The average medical cost was controlled. The expense in outpatient increased fast and in inpatient moderately. The patient ratio between outpatient and inpatient was twice than that in the past. Conclusion The outpatient of public medical care consumed excessively. The number of outpatient went down sharply to reduce the hospital medical income by four to six percent after medical reform.