目的：探讨广东省公立医院医疗收入的结构变动趋势及特征并剖析原因，为实现医疗收入结构合理化及医疗费用的有效控制提供理论支撑。方法：收集广东省488家公立医院2015年-2017年医疗收入数据，运用结构变动值、结构变动度和结构贡献率等指标分析门诊及住院收入构成及变动情况。结果：2015年-2017年门诊收入结构变动度为5.83%，西药收入、化验收入、诊察收入累计贡献率达79.13%，影响门诊收入变动的前三位：住院收入的结构变动度为10.85%，西药收入、卫生材料收入、治疗收入累计贡献率为67.69%，影响住院收入变动的前三位。结论：影响广东省公立医院医疗收入结构变动的主要是西药收入、卫生材料收入，支出构成比中人员支出提高、药品费占比降低，建议加强对药品和耗材的监管和控制，着力提高医务人员技术劳务性收入，优化收入结构，提高技术性劳动的素质和竞争力。

Objective：To explore the structural trends and characteristics of medical income in public hospitals in Guangdong Province，and to analyze the reasons and provide theoretical support for rationalizing medical income structure and effective control of medical expenses. Methods：The medical income data of 488public hospitals in Guangdong Province from 2015 to 2017 were collected. The composition and changes of outpatient and inpatient income were analyzed using indicators such as structural change value，structural change and structural contribution rate. Results：From 2015 to 2017，the rate of change in outpatient income structure was 5.83%. The income of western medicines，laboratory income and medical examination income were the main items that constituted the changes in outpatient income. The cumulative contribution rate of the three was 79.13%：the structural changes of hospital incomedegree is 10.85%. The cumulative contribution rate of western medicine income，health material income，and treatment income is 67.69%，which is the top three influencing changes in hospitalization income. Conclusion：The income of western medicine and the income of health materials are the main items affecting the changes in the medical income structure of public hospitals in Guangdong Province. In the ratio of expenditure components，the personnel expenditure is increased and the proportion of drug expenses is reduced.It is recommended to strengthen the supervision and control of medicines and consumables，improve the technical labor income of medical staff，and optimize the income structure，to improve the quality and competitiveness of technical labor.