| 引用本文：李晶晶, 康洽福, 丁榕芳, 黄绍中, 黄仙香.医保药品支付标准改革对定点医疗机构临床用药的影响——基于福建省省本级、福州市参保人员医疗费用的实证分析[J].中国卫生政策研究,2017,10(11):7-12 |
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| 医保药品支付标准改革对定点医疗机构临床用药的影响——基于福建省省本级、福州市参保人员医疗费用的实证分析 |
| 投稿时间：2017-03-26 修订日期：2017-09-24 PDF全文浏览 HTML全文浏览 |
| 李晶晶1, 康洽福2, 丁榕芳3, 黄绍中3, 黄仙香4 |
1. 福建医科大学附属协和医院 福建福州 350001;
2. 南昌铁路局福州医疗保险事业管理中心 福建福州 350013;
3. 福建省社会医疗保险协会 福建福州 350003;
4. 施维雅(天津)制药有限公司公共事务部 福建福州 350001 |
| 摘要:目的：评估福建省医保药品支付标准改革对定点医疗机构临床用药的影响。方法：分析福建省省本级、福州市医疗保险管理中心331万参保人员2016年4～9月及上年同期门诊和住院药品消费数据，按年度统计药品费用、用药情况以及医保药品支付标准政策执行情况。结果：改革前后医保药品支付标准目录内费用占比从22.50%上升为64.95%；公立医院及非公立医院改革前后门诊药品前10位一致仅排序略有变化，改革后两者门诊支付标准内费用占门诊费用比例分别为73.21%、39.30%；公立医院住院前10位药品品种及其金额变化较大，其中联合采购价差较大的药品费用增幅较高，而非公立医院相对稳定。结论：医保药品支付标准改革显著影响了临床用药品牌选择和用药结构；以药品集中采购结合联合带量采购形成的医保药品支付标准有利于降低药品价格；医保药品支付标准改革结合医药卫生体制综合改革措施更有利于发挥引导作用。 |
| 关键词:医保药品支付标准 联合采购 基本医疗保险 合理用药 |
| 基金项目:福建省社会医疗保险协会项目 |
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| The impact of medical insurance payment standard reform on clinical drug use in designated medical institutions:Based on Fujian provincial level, Fuzhou medical insurance insured personnel empirical evidence |
| LI Jing-jing1, KANG Qia-fu2, DING Rong-fang3, HUANG Shao-zhong3, HUANG Xian-xiang4 |
1. Union Hospital of the Fujian Medical University, Fuzhou Fujian 350001, China;
2. Fuzhou Medical Insurance Management Center of Nanchang Railway Administration, Fuzhou Fujian 350013, China;
3. Fujian Social Medical Insurance Association, Fuzhou Fujian 350003, China;
4. Public Affairs Department of Servier(Tianjin) Pharmaceutical Co. LTD, Fuzhou Fuzhou 350001, China |
| Abstract:Objective:To evaluate the influence of medical insurance payment standard reform on clinical drug use in designated medical institution. Methods:The medical expenses and drug consumption data of provincial level and Fuzhou medical insurance management center 3.31 million is included from April to September of 2016 and the same period of last year were statistically analyzed. The annual drug cost, drug use and the payment standard of medical insurance analysis were performed according to the annual statistics. Results:Before and after the reform, the proportion of the payment of standard drugs increased from 22.50% to 64.95%. The top 10 outpatient drugs in public hospitals and non-public hospitals were changed only in serial number, and after the reform, the cost of outpatient service fee was 73.21% and 39.30% respectively. Meanwhile, the variety and amount of drugs changed greatly of top 10 drugs public hospitals. The increase in drug cost of drugs with joint purchasing price difference was higher, and non-public hospitals were relatively stable. Conclusions:As per the findings of this study, Medicare insurance payment standard reform has significantly affected the choice of drug brands and drug use structure. To focus on the medical insurance payment standard of concentrated purchase of drugs combined with the amount of joint procurement of medicines is beneficial to reduce drug prices. The medical insurance payment standard reform combined with comprehensive reform of medical and health system measures are much more conducive to play a guiding role. |
| Key words:Medical insurance payment standard Procurement of drugs with target quantity Basic medical insurance Rational drug use |
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