It is of great significance to clarify the characteristics of the main population served by community health service institutions for the precise reform of community health service institutions in the next step.

To provide accurate data support for the next reform policy formulation and adjustment by analyzing the characteristics of the beneficiary population in terms of curative care expenditure (CCE) in community health service institutions in Beijing before and after the comprehensive reform.

The basic data of this study was obtained from the basic database of total health expenditure accounting in Beijing from 2016 to 2019, and other data was obtained from Beijing Health Statistical Yearbook, Beijing Health Financial Statistics Annual Report, and Beijing Health Expenditure Accounting Report from 2016 to 2019. The multi-stage stratified cluster sampling was adopted to select community health service institutions, and the annual out-patient data and in-patient data were included from HIS system. System of Health Accounts 2011 (SHA 2011) was used to calculate and analyze the situation of the beneficiaries of community health service institutions.

The CCE of community health service institutions in Beijing increased from 12.181 billion yuan to 22.245 billion yuan with an average annual increase of 19.07% from 2016 to 2019. The CCE of middle-aged and elderly patients over 40 years age accounted for more than 92% over the years, and CCE of patients in the age groups of 60s and 80s increased rapidly, with an average annual growth rate of 24.08% and 25.84%, respectively. Among the CCE, endocrine, nutritional and metabolic diseases, abnormal symptoms, signs and test results, circulatory system diseases accounted for the highest proportion. The CCE of endocrine, nutritional and metabolic diseases, nervous system diseases, abnormal symptoms, signs and test results increased rapidly, with an average annual growth rate of 40.11%, 48.40% and 32.43%, respectively.

The effectiveness of hierarchical diagnosis and treatment has begun to emerge after the comprehensive reform. Community medical service resources in Beijing are mainly consumed by middle-aged and elderly patients and patients with chronic non-communicable diseases such as endocrine and circulatory diseases. The comprehensive reforms guided more middle-aged and elderly people and patients with chronic diseases to community health service institutions. Community health service institutions should improve their service capacities in many aspects, such as service capacity, human resource, chronic disease management and medical consortium construction, to consolidate and maintain the effectiveness of the reform.

厘清社区卫生服务机构主要服务的人群特点，对下一步社区卫生服务机构的精准改革具有十分重要的意义。

通过分析综合改革前后北京市社区卫生服务机构治疗费用的受益人群特征，为下一步改革政策制定和调整提供精准的数据支持。

本研究基础数据来源于2016—2019年北京市卫生总费用核算基础数据库，其他数据来源于2016—2019年《北京市卫生健康统计年鉴》《北京市卫生财务统计年报》《北京市卫生费用核算报告》等。采用多阶段分层整群抽样的方案选取社区卫生服务机构，从HIS系统纳入全年的门诊数据、住院患者的数据。采用卫生费用核算体系2011（SHA2011）核算、分析社区卫生服务机构治疗费用的受益人群状况。

2016—2019年北京市社区卫生服务机构治疗费用从121.81亿元增长至222.45亿元，年均增长19.07%。40岁以上中老年患者治疗费用历年占比均在92%以上，60~岁、80~岁两个年龄组患者治疗费用增长较快，年均增速分别为24.08%、25.84%；治疗费用中内分泌、营养和代谢疾病，症状、体征和检验异常、循环系统疾病占比最高，内分泌、营养和代谢疾病，神经系统疾病，症状、体征和检验异常疾病治疗费用增长较快，年均增速分别为40.11%、48.40%和32.43%。

综合改革后分级诊疗成效初显，社区医疗服务资源主要由中老年患者、内分泌、循环系统等慢性非传染性疾病患者所消耗，改革引导更多中老年和慢性病患者流向社区，社区卫生服务机构应该从服务能力、人才队伍、慢性病管理、医联体建设等多方面着手，提升其服务能力，巩固和维持改革的效果。