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上海县纪王公社卫生院有58名医务人员,21张床位,担负了全公社1.32万人和十个市属和县属单位的医疗卫生工作。1980年以来在各级党委的领导和县卫生局的业务指导下,加强卫生院管理,各方面工作取得了较大的成绩。平均每人次门诊费用由1979年的1.19元下降到1980年的1.01元和1981年的0.97元,两年中下降了0.22元。由于门诊服务量增加(1981年门诊人次数比1979年增加43％),门诊总收入1981年比1979年增加7792元,占1979年门诊总收入的17％。1980年曾出现一定程度开大处方的现象,加强管理后,处方单价恢复到1979年的水平。化验项目主要包括血、尿、粪三大常规检查,生化检验和验痰等。1979年到1980年平均每次检验费逐年降低,分别为0.37元、0.35元和0.29元,而检验总次数逐年增加,使得化验费总收入三年基本相近,分别为2171元、2288元和2217元。在医疗服务量增加的同时,业务出支逐年减少,1981年比1979年减少支出870元。以上事实说明,加强卫生院管理必须以全局着眼,兼顾国家、集体和病人三者的利益,从这三方面来评价卫生院管理的经济效果和利益。由此提出建立适当的卫生经济评价指标,如平均每人次门诊费用、平均处方单价、平均每次检查费用等。
The Ji County Community Hospital in Shanghai County has 58 medical personnel and 21 beds. It is responsible for the medical work of 13,200 people in the entire communes and 10 municipalities and county units. Since 1980, under the leadership of party committees at all levels and under the guidance of county health bureaus, the management of hospitals has been strengthened, and all aspects of work have achieved significant results. The average per-patient visit fee dropped from 1.19 yuan in 1979 to 1.01 yuan in 1980 and 0.97 yuan in 1981, a decrease of 0.22 yuan in two years. As the outpatient service volume increased (the number of outpatients in 1981 increased by 43% compared with 1979), the total outpatient income increased by 7792 yuan in 1981 compared with 1979, accounting for 17% of total outpatient income in 1979. In 1980, there was a phenomenon that a certain degree of prescription was opened up. After strengthening management, the prescription unit price recovered to the level of 1979. Laboratory items include blood, urine, and feces three major routine inspections, biochemical tests, and laboratory tests. From 1979 to 1980, the average inspection fee per year decreased by 0.37 yuan, 0.35 yuan, and 0.29 yuan respectively, and the total number of inspections increased year by year, making the total revenue of laboratory fees nearly the same for three years, at 2,171 yuan, 2,288 yuan, and 2,217 yuan respectively. yuan. With the increase in the volume of medical services, business expenditures have been decreasing year by year, and expenditures have been reduced by 870 yuan in 1981 compared with 1979. The above facts indicate that the strengthening of the management of hospitals must focus on the overall situation, taking into account the interests of the state, the collective, and the patient, and evaluate the economic effects and benefits of hospital management from these three aspects. This proposed the establishment of appropriate health economic evaluation indicators, such as the average person-to-person outpatient expenses, the average prescription unit price, and the average cost per visit.