2026 年第 2 期 第 21 卷

北京市三级公立综合性医院医疗资源冗余状况及对医疗费用的影响研究

Research on the medical resource redundancy status and its impact on medical expenses in tertiary public general hospitals in Beijing

作者：宋鑫瑞1周小平2朱俊利3,4

英文作者：Song Xinrui1 Zhou Xiaoping2 Zhu Junli34

单位：1首都医科大学附属北京胸科医院党委办公室，北京101149；2首都医科大学附属北京胸科医院财务处，北京101149；3首都医科大学公共卫生学院，北京100069；4首都卫生管理与政策研究中心，北京100069

英文单位：1Office of the Party Committee Beijing Chest Hospital Capital Medical University Beijing 101149 China; 2Financial Department Beijing Chest Hospital Capital Medical University Beijing 101149 China; 3School of Public Health Capital Medical University Beijing 100069 China; 4Capital Health Management and Policy Research Center Beijing 100069 China

关键词：公立医院；冗余资源；医疗费用

英文关键词：Publichospitals;Redundantresource;Medicalexpense

• 摘要：

• 目的 测算公立医院医疗资源冗余状况，以及其对医疗费用的影响，为管理者有效衡量、利用冗余资源以合理控制其医疗费用提供理论与实践依据。方法 基于组织冗余理论，以2018—2022年北京市34家三级公立综合性医院为研究对象，通过比值法测量床位、医生、护士资源冗余状况，构建面板模型实证分析医疗资源冗余对医疗费用的影响。结果44.12%～58.82%的医院为无冗余状态，20.59%～47.06%的医院为低度冗余状态，5.88%～23.53%的医院为高度冗余状态。冗余资源与次均费用为正线性关系；医生、床位冗余资源与例均费用为U型关系，护士冗余资源与例均费用为转置S型关系。结论 北京市部分三级公立综合性医院存在医疗资源冗余，且当冗余资源增长至一定范围后会增加医疗费用。公立医院应遵循其公益性，在充分衡量医疗需求的基础上，科学进行资源配置，防止医疗资源过度增长，合理控制医疗费用，承担起相应的社会责任。

• Objective To measure the medical resource redundancy status in public hospitals and its impact on medical expenses, so as to provide theoretical and practical basis for managers to effectively measure and utilize redundant resources to reasonably control medical expenses. Methods Based on the organizational redundancy theory, a total of 34 tertiary public general hospitals in Beijing from 2018 to 2022 were selected as the research objects. The ratio method was used to measure the redundancy status of bed, doctor and nurse resources, and a panel model was constructed to empirically analyze the impact of medical resource redundancy on medical expenses. Results 44.12%-58.82% of the hospitals were in a non-redundant state, 20.59%-47.06% were in a low-redundant state, and 5.88%-23.53% were in a high-redundant state. There was a positive linear relationship between redundant resources and average cost per visit. The redundant resources of doctors and beds had a U-shaped relationship with average cost per case, while the redundant resources of nurses had an inverted S-shaped relationship with average cost per case. Conclusions Some tertiary public general hospitals in Beijing have medical resource redundancy, and when the redundant resources increase to a certain range, medical expenses will increase. Public hospitals should adhere to their public welfare, scientifically allocate resources on the basis of fully measuring medical needs, prevent excessive growth of medical resources, reasonably control medical expenses, and assume corresponding social responsibilities.