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Article(id=1324044618244961205, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324044540067328424, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202512106, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1764950400000, receivedDateStr=2025-12-06, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793606436548, onlineDateStr=2026-11-02, pubDate=1777046400000, pubDateStr=2026-04-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793606436548, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793606436548, creator=13701087609, updateTime=1793606436548, updator=13701087609, issue=Issue{id=1324044540067328424, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='8', pageStart='1345', pageEnd='1536', issueExtLink='null', onlineDate='null', pubDate='1777046400000', pubDateStr='2026-04-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793606417910, creator='13701087609', updateTime=1793670137580, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324311799788602160, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324044540067328424, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324311799788602161, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324044540067328424, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=1447, endPage=1452, ext={EN=ArticleExt(id=1324044618521785270, articleId=1324044618244961205, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Analysis on the coupling coordination between medical service price and social economic development: A case study of Sichuan Province, columnId=1228016567846367388, journalTitle=Modern Preventive Medicine, columnName=Health Policy and Management, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the coupling and coordination relationship between medical service price and social economic development in Sichuan Province, and provide references for deepening medical service price reform and promoting regional linkage and coordinated development.

Methods

The coupling coordination degree model was used to evaluate the coupling coordination degree between medical service price and social economic development, and the coupling coordination grade and type were clarified.

Results

From 2017 to 2022, the coupling coordination degree between medical service price and social economic development in Sichuan Province showed an upward trend. Among the five economic regions, only the coupling coordination degree of Northwest Sichuan Ecological Demonstration Zone showed a downward trend, while the other four regions showed an upward trend. Specifically speaking, Chengdu ranked first in coupling coordination degree, belonging to intermediate coordination, while Ganzi and Aba were at the end, belonging to serious imbalance. From high to low, the proportion of coupling coordination type was lagged medical service price type, synchronized medical service price and social economic development type, lagged social economic development type.

Conclusion

The coupling coordination trend of the two systems in Sichuan Province is generally good, but the coordination degree is not high, and there are significant regional differences. Generally, it belongs to the lag coordination of medical service prices.

, authors=Pei XIAO1, Xuan-ping ZHOU1, Yan ZHANG2, authorsList=Pei XIAO, Xuan-ping ZHOU, Yan ZHANG, authorCompany=null, correspAuthors=Yan ZHANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324044622418293705, articleId=1324044618244961205, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=四川省医疗服务价格与社会经济发展耦合协调分析, columnId=1228016568014139551, journalTitle=现代预防医学, columnName=卫生政策与管理, runingTitle=null, highlight=null, articleAbstract=
目的

探析四川省医疗服务价格与社会经济发展的耦合协调关系，为深化医疗服务价格改革，推动区域联动协调发展提供参考。

方法

运用耦合协调度模型测评医疗服务价格与社会经济发展的耦合协调度，明晰耦合协调等级及类型。

结果

2017—2022年四川省医疗服务价格与社会经济发展的耦合协调度总体呈现波动上升趋势。五大经济区域中，仅川西北生态示范区的耦合协调度呈现波动下降趋势，而余下四个区域均呈现波动上升趋势。具体地区而言，成都市耦合协调度位居第一，属于中级协调，而甘孜州与阿坝州居于末端，属于严重失调。耦合协调类型的地区数量占比由高到低依次是医疗服务价格滞后型、医疗服务价格与社会经济发展同步型、社会经济发展滞后型。

结论

四川省两类系统耦合协调趋势总体向好，但协调程度不高，存在显著区域差异，总体上属于医疗服务价格滞后型协调。

, authors=肖沛1, 周玄平1, 张妍2, authorsList=肖沛, 周玄平, 张妍, authorCompany=null, correspAuthors=张妍, authorNote=

肖沛（1989—），女，本科，助理研究员，研究方向：卫生经济与政策

, correspAuthorsNote=
张妍，E-mail：
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肖沛（1989—），女，本科，助理研究员，研究方向：卫生经济与政策

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肖沛（1989—），女，本科，助理研究员，研究方向：卫生经济与政策

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(In Chinese), articleTitle=Evaluating the Macro-Control effect of medical service price level using the coupled coordination degree model and recommendations, refAbstract=null), Reference(id=1324044635185754143, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044618244961205, doi=null, pmid=null, pmcid=null, year=2022, volume=41, issue=11, pageStart=42, pageEnd=47, url=null, language=null, rfNumber=[21], rfOrder=40, authorNames=李丽清, 黄嘉雯, 杨苏乐, journalName=中国卫生经济, refType=null, unstructuredReference=李丽清, 黄嘉雯, 杨苏乐, 等. 健康中国视角下江西省医疗资源配置与经济高质量耦合协调发展研究[J]. 中国卫生经济, 2022, 41(11): 42-47., articleTitle=健康中国视角下江西省医疗资源配置与经济高质量耦合协调发展研究, refAbstract=null), Reference(id=1324044635286417440, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044618244961205, doi=null, pmid=null, pmcid=null, year=2022, volume=41, issue=11, pageStart=42, pageEnd=47, url=null, language=null, rfNumber=[21], rfOrder=41, authorNames=Li LQ, Huang JW, Yang SL, journalName=Chinese Health Economics, refType=null, unstructuredReference=Li LQ, Huang JW, Yang SL, et al. Research on coupling and coordinated development of medical resource allocation and economic high-quality in Jiangxi province from the perspective of healthy China[J]. Chinese Health Economics, 2022, 41(11): 42-47. (In Chinese), articleTitle=Research on coupling and coordinated development of medical resource allocation and economic high-quality in Jiangxi province from the perspective of healthy China, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1324044622648980426, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044618244961205, xref=1., ext=[AuthorCompanyExt(id=1324044622661563339, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044618244961205, companyId=1324044622648980426, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, China), AuthorCompanyExt(id=1324044622669951948, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044618244961205, companyId=1324044622648980426, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.四川大学华西第四医院，四川　成都　610041)]), AuthorCompany(id=1324044622737060813, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044618244961205, xref=2., ext=[AuthorCompanyExt(id=1324044622745449422, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044618244961205, companyId=1324044622737060813, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.航天医疗健康科技集团有限公司)])], figs=[ArticleFig(id=1324044626323190763, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044618244961205, language=EN, label=Fig. 1, caption=Overall coupling coordination degree in Sichuan Province, 2017-2022, figureFileSmall=dv7JOtsk2sx0xILDuvLTUg==, figureFileBig=hPk4NKtQ3Nzd7jiynLmiWw==, tableContent=null), ArticleFig(id=1324044626407076844, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044618244961205, language=CN, label=图1, caption=2017—2022年四川省整体的耦合协调度, figureFileSmall=dv7JOtsk2sx0xILDuvLTUg==, figureFileBig=hPk4NKtQ3Nzd7jiynLmiWw==, tableContent=null), ArticleFig(id=1324044626608403437, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044618244961205, language=EN, label=Fig. 2, caption=Coupling coordination degree across different economic regions in Sichuan Province, figureFileSmall=DjOrtUBX3lixW6PSv2tMYg==, figureFileBig=pcmQxPupmXmDFCtCP1Q8dQ==, tableContent=null), ArticleFig(id=1324044626692289518, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044618244961205, language=CN, label=图2, caption=四川省不同经济区域的耦合协调度

注：A表示门诊医疗服务费；B表示住院医疗服务费。

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注：A表示门诊医疗服务费；B表示住院医疗服务费。

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Criteria for determining coupling coordination level

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序号取值范围耦合协调等级
10≤D≤0.1极度失调
20.1<D≤0.2严重失调
30.2<D≤0.3中度失调
40.3<D≤0.4轻度失调
50.4<D≤0.5濒临失调
60.5<D≤0.6勉强协调
70.6<D≤0.7初级协调
80.7<D≤0.8中级协调
90.8<D≤0.9良好协调
100.9<D≤1.0优质协调
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耦合协调等级判断标准

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序号取值范围耦合协调等级
10≤D≤0.1极度失调
20.1<D≤0.2严重失调
30.2<D≤0.3中度失调
40.3<D≤0.4轻度失调
50.4<D≤0.5濒临失调
60.5<D≤0.6勉强协调
70.6<D≤0.7初级协调
80.7<D≤0.8中级协调
90.8<D≤0.9良好协调
100.9<D≤1.0优质协调
), ArticleFig(id=1324044627136885747, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044618244961205, language=EN, label=Table 2, caption=

Criteria for determining coupling coordination type

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序号取值范围耦合协调类型
10≤PI/SI<0.9医疗服务价格滞后型
20.9≤PI/SI≤1.2医疗服务价格与社会经济发展同步型
3PI/SI>1.2社会经济发展滞后型
), ArticleFig(id=1324044627216577524, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044618244961205, language=CN, label=表2, caption=

耦合协调类型判断标准

, figureFileSmall=null, figureFileBig=null, tableContent=
序号取值范围耦合协调类型
10≤PI/SI<0.9医疗服务价格滞后型
20.9≤PI/SI≤1.2医疗服务价格与社会经济发展同步型
3PI/SI>1.2社会经济发展滞后型
), ArticleFig(id=1324044627275297781, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044618244961205, language=EN, label=Table 3, caption=

Coordination distribution across different regions of Sichuan Province in 2022

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协调类型门诊住院
地区数量（%）地区数量（%）
社会经济发展滞后型遂宁市、巴中市2（9.52）广元市、遂宁市、南充市、达州市、巴中市、资阳市6（28.57）
医疗服务价格与社会经济发展同步型成都市、广元市、内江市、广安市、达州市、凉山州6（28.57）成都市、自贡市、泸州市、绵阳市、内江市、广安市、凉山州7（33.33）
医疗服务价格滞后型自贡市、攀枝花市、泸州市、德阳市、绵阳市、乐山市、南充市、眉山市、宜宾市、雅安市、资阳市、阿坝州、甘孜州13（61.91）攀枝花市、德阳市、乐山市、眉山市、宜宾市、雅安市、阿坝州、甘孜州8（38.10）
), ArticleFig(id=1324044627342406646, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044618244961205, language=CN, label=表3, caption=

2022年四川省不同地区的协调分布情况

, figureFileSmall=null, figureFileBig=null, tableContent=
协调类型门诊住院
地区数量（%）地区数量（%）
社会经济发展滞后型遂宁市、巴中市2（9.52）广元市、遂宁市、南充市、达州市、巴中市、资阳市6（28.57）
医疗服务价格与社会经济发展同步型成都市、广元市、内江市、广安市、达州市、凉山州6（28.57）成都市、自贡市、泸州市、绵阳市、内江市、广安市、凉山州7（33.33）
医疗服务价格滞后型自贡市、攀枝花市、泸州市、德阳市、绵阳市、乐山市、南充市、眉山市、宜宾市、雅安市、资阳市、阿坝州、甘孜州13（61.91）攀枝花市、德阳市、乐山市、眉山市、宜宾市、雅安市、阿坝州、甘孜州8（38.10）
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四川省医疗服务价格与社会经济发展耦合协调分析
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肖沛 1 , 周玄平 1 , 张妍 2
现代预防医学 | 卫生政策与管理 2026,53(8): 1447-1452
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现代预防医学 |卫生政策与管理 2026 , 53 (8) : 1447 -1452
四川省医疗服务价格与社会经济发展耦合协调分析
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肖沛1, 周玄平1, 张妍2
作者信息
  • 1.四川大学华西第四医院，四川　成都　610041
  • 2.航天医疗健康科技集团有限公司
通讯作者:
张妍，E-mail：
作者简介:

肖沛（1989—），女，本科，助理研究员，研究方向：卫生经济与政策

Analysis on the coupling coordination between medical service price and social economic development: A case study of Sichuan Province
Pei XIAO1, Xuan-ping ZHOU1, Yan ZHANG2
Affiliations
  • West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, China
出版时间: 2026-04-25 doi: 10.20043/j.cnki.MPM.202512106
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摘要
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目的

探析四川省医疗服务价格与社会经济发展的耦合协调关系，为深化医疗服务价格改革，推动区域联动协调发展提供参考。

方法

运用耦合协调度模型测评医疗服务价格与社会经济发展的耦合协调度，明晰耦合协调等级及类型。

结果

2017—2022年四川省医疗服务价格与社会经济发展的耦合协调度总体呈现波动上升趋势。五大经济区域中，仅川西北生态示范区的耦合协调度呈现波动下降趋势，而余下四个区域均呈现波动上升趋势。具体地区而言，成都市耦合协调度位居第一，属于中级协调，而甘孜州与阿坝州居于末端，属于严重失调。耦合协调类型的地区数量占比由高到低依次是医疗服务价格滞后型、医疗服务价格与社会经济发展同步型、社会经济发展滞后型。

结论

四川省两类系统耦合协调趋势总体向好，但协调程度不高，存在显著区域差异，总体上属于医疗服务价格滞后型协调。

医疗服务价格  /  社会经济发展  /  协调等级  /  协调类型  /  耦合协调度  /  四川
Objective

To explore the coupling and coordination relationship between medical service price and social economic development in Sichuan Province, and provide references for deepening medical service price reform and promoting regional linkage and coordinated development.

Methods

The coupling coordination degree model was used to evaluate the coupling coordination degree between medical service price and social economic development, and the coupling coordination grade and type were clarified.

Results

From 2017 to 2022, the coupling coordination degree between medical service price and social economic development in Sichuan Province showed an upward trend. Among the five economic regions, only the coupling coordination degree of Northwest Sichuan Ecological Demonstration Zone showed a downward trend, while the other four regions showed an upward trend. Specifically speaking, Chengdu ranked first in coupling coordination degree, belonging to intermediate coordination, while Ganzi and Aba were at the end, belonging to serious imbalance. From high to low, the proportion of coupling coordination type was lagged medical service price type, synchronized medical service price and social economic development type, lagged social economic development type.

Conclusion

The coupling coordination trend of the two systems in Sichuan Province is generally good, but the coordination degree is not high, and there are significant regional differences. Generally, it belongs to the lag coordination of medical service prices.

Medical service price  /  Social economic development  /  Coordination level  /  Coordination type  /  Coupling coordination degree  /  Sichuan
肖沛, 周玄平, 张妍. 四川省医疗服务价格与社会经济发展耦合协调分析. 现代预防医学, 2026 , 53 (8) : 1447 -1452 . DOI: 10.20043/j.cnki.MPM.202512106
Pei XIAO, Xuan-ping ZHOU, Yan ZHANG. Analysis on the coupling coordination between medical service price and social economic development: A case study of Sichuan Province[J]. Modern Preventive Medicine, 2026 , 53 (8) : 1447 -1452 . DOI: 10.20043/j.cnki.MPM.202512106
正文
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医疗服务价格直接关系公众的核心利益，是备受社会关注的民生焦点，同时也是推进医疗保障和医疗服务高质量发展的重要改革内容[1-2]。但是长期以来医疗服务价格存在比价不合理，调价周期滞后，缺乏有效的动态调整机制等问题[3]。为持续优化医疗服务价格结构，国家医保局等八部委于2021年8月印发《深化医疗服务价格改革试点方案》（医保发〔2021〕41号）。该方案旨在构建一套与经济发展水平相适应、政府引导作用更加有效、医疗机构广泛参与，并充分反映技术劳务价值的医疗服务价格形成机制[4-5]。这从政策顶层设计上要求医疗服务价格改革要与社会经济发展水平相协调。其适配程度对于推动卫生健康事业高质量发展、实现“健康中国”战略目标具有重要意义。已有研究多集中于探讨医疗服务价格动态调整机制[6-7]、定价模型[8-9]、比价关系[10-11]等，鲜有从系统耦合视角出发针对医疗服务价格与社会经济发展的耦合协调程度进行分析。因此，本研究以四川省为例，借助耦合协调度模型，对当地医疗服务价格与社会经济发展之间的耦合协调关系进行测算分析，从而把握二者间的相对发展动态，以期为优化医疗服务价格政策，推动区域联动协调发展提供决策参考。
1　资料与方法
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1.1　资料来源
本研究选取四川省全部21个市（州）作为分析样本，依据该省经济区域划分标准，设置为五个区域，具体包括：成都平原经济区、川南经济区、川东北经济区、攀西经济区以及川西北生态示范区。研究资料来源于官方统计年鉴，其中医疗服务价格数据取自《四川卫生健康统计年鉴（2017—2022）》，而社会经济发展数据则来自《四川统计年鉴（2018—2023）》。
1.2　研究指标
参考王海银等[12]学者的研究，以次均门诊费用与次均住院费用（二者均扣除药费与检查治疗费）来间接反映地区医疗服务价格水平。这一处理主要是由于在扣除前述费用后，该指标融合了各地区的医疗服务项目价格及服务提供量，能够基于现实世界中各类医疗服务项目组合使用的加权情况，对价格水平进行间接体现。依据四川省医疗保障局、四川省卫生健康委员会两部门发布的《关于建立医疗服务价格动态调整机制的实施意见（试行）》（川医保规〔2022〕11号）[13]，本研究选取人均地区生产总值、居民消费价格指数作为衡量社会经济发展的核心指标。
1.3　研究方法
1.3.1　综合评价指数
由于评价指标水平差异较大，故需对原始数据标准化处理后，然后再采用熵权法确定社会经济发展指标的权重值。标准化处理及熵权计算过程参照了王海银等[1]的研究。
（1）评价指标标准化处理
式（1）中，Sij代表地区i的第j项评价指标的标准化值，xij表示地区i的第j项评价指标的原始值。
（2）计算评价指标熵权
式（2）中，Wj释义第j项评价指标权重，n表示评价指标数。
（3）计算综合评价指数
本文将次均门诊费用与次均住院费用的标准化数据直接视为各自的医疗服务价格评价指数（medical service price evaluation index，PI），而社会经济发展评价指数（socio-economic evaluation index，SI）则运用线性加权法进行计算，见式（3）。
1.3.2　耦合协调度模型
采用耦合协调度模型分析医疗服务价格与社会经济发展的协调关系，用以反映系统要素间相互作用、彼此影响的程度[14-15]。计算公式为：
式（4）~式（6）中，D、C、T分别表示耦合协调度、耦合度、社会经济发展与医疗服务价格的整体综合评价指数。λ是医疗服务价格的贡献系数，μ是社会经济发展的贡献系数，且λ+μ=1，此处认为两类系统重要性相同[16]，故将λ、μ均设置为0.5。本文参考既往学者研究[17-18]，耦合协调等级与类型的划分标准如下：
2　结果
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2.1　四川省医疗服务价格与社会经济发展的耦合协调总体情况
2017—2022年，四川省医疗服务价格与社会经济发展之间的耦合协调度，整体在波动中保持上升态势。其中，门诊医疗服务费与社会经济发展的耦合协调度由2017年的0.374 9波动升至2022年的0.416 9。住院医疗服务费与社会经济发展的耦合协调度由2017年的0.425 5波动升至2022年的0.461 3。见图1。
2.2　不同经济区域医疗服务价格与社会经济发展的耦合协调评价
五大经济区域中，除川西北生态示范区外，余下区域医疗服务价格与社会经济发展的耦合协调度均呈现波动上升趋势。观之门诊医疗服务费，2017—2022年不同经济区域的耦合协调度均值分别为：成都平原经济区0.432 9，川南经济区0.373 7，川东北经济区0.385 4，攀西经济区0.387 0，川西北生态示范区0.276 6。成都平原经济区与川西北生态示范区分别处于濒临失调、中度失调状态，川南经济区、川东北经济区与攀西经济区均处于轻度失调状态。再视住院医疗服务费，六年间各经济区域的耦合协调度均值依次为：成都平原经济区0.506 3、川南经济区0.468 2、川东北经济区0.402 9、攀西经济区0.418 6、川西北生态示范区0.249 4。成都平原经济区与川西北生态示范区分别处于勉强协调、中度失调状态，而其他三大经济区均处于濒临失调状态。见图2。
2.3　不同地区医疗服务价格与社会经济发展的耦合协调评价
2.3.1　耦合协调等级情况
门诊医疗服务费方面，2022年四川省医疗服务价格与社会经济发展的耦合协调度排名前五的地区分别是成都市（0.703 3）、攀枝花市（0.527 2）、绵阳市（0.525 4）、德阳市（0.515 2）与遂宁市（0.509 9），而凉山州（0.262 4）与甘孜州（0.166 2）位居末端。总体而言，处于中级协调、勉强协调、濒临失调、轻度失调、中度失调、严重失调的地区比重分别为4.76%、19.05%、33.33%、33.33%、4.76%、4.76%。住院医疗服务费方面，耦合协调度排名前五的地区分别是成都市（0.703 3）、攀枝花市（0.582 4）、德阳市（0.575 5）、绵阳市（0.569 6）与泸州市（0.543 0），而凉山州（0.257 5）与阿坝州（0.185 0）居于末端。整体上，处于中级协调、勉强协调、濒临失调、轻度失调、中度失调、严重失调的地区比重分别为4.76%、38.10%、33.33%、9.52%、9.52%、4.76%。见图3。
2.3.2　耦合协调分布类型
耦合协调类型代表了医疗服务价格相对于社会经济的发展情况，划分的三个类别分别释义社会经济发展滞后于医疗服务价格、医疗服务价格同步于社会经济发展、医疗服务价格滞后于社会经济发展。2022年四川省医疗服务价格与社会经济发展的耦合协调类型的地区数量占比由高到低依次是医疗服务价格滞后型、医疗服务价格与社会经济发展同步型、社会经济发展滞后型。门诊医疗服务费中，自贡市、攀枝花市、泸州市等13个地区属于医疗服务价格滞后型，占61.91%，而遂宁市、巴中市则属于社会经济发展滞后型，占9.52%。住院医疗服务费中，8个地区属于医疗服务价格滞后型（38.10%），而社会经济发展滞后型有6个地区（28.57%）。见表3。
3　讨论
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本研究采用耦合协调度模型以定量方式刻画了医疗服务价格与社会经济发展之间的耦合协调关系及短板。研究发现，2017—2022年四川省两类系统耦合协调趋势总体向好，但协调程度不高，介于轻度失调~濒临失调。这与李雪等[16]研究湖北省六市州的结果较为类似。分析原因，四川省相继于2016—2018年施行公立医院取消药品加成政策、医疗服务项目价格结构性调整政策、取消医用耗材加成政策，并按照总量基本平衡、按比补平减收等原则调整了部分医疗服务项目价格[19]。经过三次全省范围内的医疗服务价格政策改革，价格合理性逐渐得到改善，尤其是体现医务人员技术劳务价值的项目价格，这也是社会经济良性发展的间接反映，故两类系统的耦合协调性呈现总体向好趋势。值得注意的是，二者的协调程度不高，提示当前医疗服务价格改革还应持续深入开展。因此，建议价格规制部门进一步规范管理医疗服务价格项目，建立灵敏有度的价格动态调整机制以及严密高效的价格监测机制，以引导各地区合理制定符合本地实际情况的医疗服务价格，稳步提升与社会经济发展的耦合协调性。
与既往相关研究一致[1]，四川省医疗服务价格与社会经济发展的耦合协调度亦存在显著区域差异。研究显示在五大经济区域中，仅川西北生态示范区的耦合协调度呈现波动下降趋势，而余下四个区域均呈现波动上升趋势。尤其观之耦合协调度平均水平，成都平原经济区明显高于川西北生态示范区。这在地区层面的分析中也得到了较好的验证，无论门诊还是住院医疗服务，成都市的耦合协调度均位居第一，甘孜州与阿坝州则排列末端。究其原因，一是各地区在管理上实施分类施策且定价具有自主差异，这直接导致了医疗服务价格政策出现地域性区别。具体而言，前述省级层面医疗服务价格政策在推进过程中，不同地区的改革时间窗、补偿结构与比例、价格调整项目、医保支付衔接等均存在一定差异。二是不同区域经济发展水平参差不齐，四川省经济发展总量主要集中于成都平原经济区。因此，建议完善医疗服务价格在跨区域间的协调联动机制，强化协同，并持续优化管理模式，理顺地区间医疗服务比价关系，从而提升医疗服务价格的区域均衡性[20]。同理，另一方面也要平衡区域经济发展，通过系统性的战略布局，释放不同区域的发展动能，逐步缩小经济差距。
总体来看，四川省属于医疗服务价格滞后型协调，即医疗服务价格滞后于社会经济发展。在门诊医疗服务费中，医疗服务价格滞后型、医疗服务价格与社会经济发展同步型、社会经济发展滞后型三者所占比重依次为61.91%、28.57%、9.52%，而在住院医疗服务费中，三者的比重分别是38.10%、33.33%、28.57%。这与王海银等[1]分析长三角地区27个城市的结果较为类似。研究提示耦合协调类型所表现出的地区差异，需要根据不同地区的具体情境施行政策优化，从而提升整体效能。针对医疗服务价格滞后型地区，建议按照四川省深化医疗服务价格改革试点实施方案的要求，充分考虑费用变化、社会发展、要素成本、改革引导、承受能力等五大方面因素，综合设置启动条件与约束条件，以及相应的参照标准。通用型医疗服务项目原则上1至2年开展一次调价评估，在达到调价启动条件且未触发约束条件时即可进行价格调整，而复杂型医疗服务项目建议实施年度调价评估机制。在符合既定条件的情况下，可集中受理并启动公立医院提出的价格调整建议[5]。当然，也要灵活选择调价窗口期开展医疗服务价格专项调整，以应对重大改革任务。对于社会经济发展滞后型地区，政府应学习其他地区的高质量发展经验，积极探索适宜于本地区的经济发展道路[21]，如完善基础设施、培育特色产业、提升人力资本、推进制度创新等，多措并举提升软硬实力，促进社会经济与医疗服务价格良性协调发展。
综上所述，2017—2022年四川省医疗服务价格与社会经济发展的耦合协调趋势总体向好，但协调程度不高，存在显著区域差异。协调类型方面，总体上属于医疗服务价格滞后型协调。未来应持续深入开展医疗服务价格改革，重点关注区域存在的差距，根据不同协调类型，分类科学施策，共促高质量发展。此外，本研究尚存一定的局限性。首先，因官方统计年鉴更新较慢，未能纳入最新年度的数据资料进行分析。其次，研究仅探讨了地区整体医疗服务价格水平，未能以具体医疗服务项目为例，揭示与社会经济发展的耦合协调性。

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2026年第53卷第8期
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doi: 10.20043/j.cnki.MPM.202512106
  • 接收时间：2025-12-06
  • 首发时间：2026-11-02
  • 出版时间：2026-04-25
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  • 收稿日期：2025-12-06
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    1.四川大学华西第四医院，四川　成都　610041
    2.航天医疗健康科技集团有限公司

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