| 引用本文：霍兆桦, 何世英, 张崖冰, 白鸽, 李婉莹, 张天天, 周帅, 熊雪晨, 周奕男, 周良, 戴瑞明, 罗力.一个贫困县实施基本药物制度引致的医疗机构损益研究[J].中国卫生政策研究,2017,10(12):39-43 |
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| 一个贫困县实施基本药物制度引致的医疗机构损益研究 |
| 投稿时间：2017-07-08 修订日期：2017-10-01 PDF全文浏览 HTML全文浏览 |
| 霍兆桦1, 何世英1, 张崖冰2, 白鸽1, 李婉莹3, 张天天1, 周帅1, 熊雪晨1, 周奕男1, 周良1, 戴瑞明1, 罗力1 |
1. 复旦大学公共卫生学院 上海 200032;
2. 上海应用技术大学人文学院 上海 201418;
3. 上海交通大学医学院附属新华医院 上海 200092 |
| 摘要:目的：分析基本药物制度引致的医疗机构的损益。方法：以我国西部某贫困县为样本地区，采用现场调查法收集资料，选取2009年为基准年，比较分析样本地区全部政府办医疗机构在2010—2015年间由于药品政策、医疗服务价格调整和财政补助调整所造成的损益及损益率。结果：基本药物制度实施后，医疗机构整体得益，且其得益呈现逐年增加的趋势，得益率从2010年的-2.15%增长到2015年的47.70%；对不同级别医疗机构的进一步分析显示，各自损益的归因各不相同，村卫生室和乡镇卫生院得益主要归因于政府补助调整，而县级医院得益主要归因于医疗服务价格调整。结论：基本药物制度的落实对于调整医疗机构损益来源的构成有一定作用，推进基本药物制度实施过程中，应进一步确保医疗机构平稳运行和发展，着重调整乡镇卫生院医疗服务价格。 |
| 关键词:基本药物制度 医疗机构 损益 损益率 |
| 基金项目:国家自然科学基金项目（71473045）；教育部哲学社会科学研究重大课题攻关项目（15JZD029） |
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| Losses and gains of medical facilities induced by implementing the Essential Medicines System in a poverty-stricken county |
| HUO Zhao-hua1, HE Shi-ying1, ZHANG Ya-bing2, BAI Ge1, LI Wan-ying3, ZHANG Tian-tian1, ZHOU Shuai1, XIONG Xue-chen1, ZHOU Yi-nan1, ZHOU Liang1, DAI Rui-ming1, LUO Li1 |
1. School of Public Health, Fudan University, Shanghai 200032, China;
2. Shanghai Institute of Technology, Shanghai 201418, China;
3. Xinhua Hospital Affiliated to Medical School of Shanghai Jiaotong University, Shanghai 200092, China |
| Abstract:Objective:To analyze losses and gains (L&G) of basic medical institutions induced by the Essential Medicines Policy.Methods:Choosing some poverty-stricken county in western China as sample area to conduct field research, using 2009 as baseline year, to calculate L&G and L&G ratio of basic medical institutions caused by adjustments of drug policy, medical services prices, and government subsidies from 2009-2015. Results:Medical facilities have gained after the implementation of the Essential Medicines Policy as a whole. Gains were on an upward trend from 2009-2015, and L&G ratio increased from -2.15% in 2009 to 47.70% in 2015. For medical facilities at different levels, their gains attributed to different causes. Gains for medical facilities at village and town levels mainly attributed to government subsidies; gains for medical facilities at county level mainly attributed to adjustment of medical services prices. Conclusions:Implementation of the Essential Medicines Policy has helped adjust composition of losses and gains of medical facilities. Moving forward, functions and development of medical facilities should be strengthened with a focus on adjusting medical services prices for medical facilities at town level. |
| Key words:Essential Medicines System Medical facilities Losses and gains (L&G) L&G ratio |
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