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基本药物制度对乡镇卫生院收入结构的影响——基于山西省的调查研究
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| 投稿时间： 2015-02-08 最后修改时间： 2015-03-21 摘要点击次数: 2599 全文下载次数: 1402 |
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| 引用本文：迟垚, 吴群红, 李斌,等.基本药物制度对乡镇卫生院收入结构的影响——基于山西省的调查研究[J].中国卫生政策研究,2015,8(4):31-34 |
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| 迟垚1, 吴群红1, 李斌2, 高力军1, 李叶1, 梁立波1, 丁玎1, 宋健1, 郝模3 |
1. 哈尔滨医科大学公共卫生学院 黑龙江哈尔滨 150081;
2. 国家卫生计生委财务司 北京 100044;
3. 复旦大学卫生发展战略研究中心 上海 200032 |
| 基金项目:国家自然科学基金重点资助项目(71333003);国家自然科学基金资助项目(71373062);健康领域社会风险预测治理协同创新中心项目 |
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| | 摘要:目的:分析基本药物制度对基层医疗机构收入结构的影响。方法:对山西省实施基本药物制度的58家乡镇卫生院的收入状况与结构变化趋势进行分析。结果:随着政府对基层医疗机构投入的增加, 基本药物制度基本实现全覆盖, 基本药物收入占药品收入比重从2009年的20.45%上升到2013年97.03%, 药品收入占总收入的比重下降了18.4%;与此同时, 财政补助收入占总收入的比重从2009年的25.77%上升到2013年的54.16%, 但业务收入占总收入比重总体呈下降趋势。结论:基本药物制度需要政府财政的大力支持, 在进一步完善基层基本药物清单和基层财政补助政策的同时, 完善医生薪酬和激励机制并改革不合理的医生劳务定价和补偿机制。 | |
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关键词:基本药物制度 乡镇卫生院 收入结构
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| Impacts of essential medicine system on revenue structure: Evidence from township health center in Shanxi Province |
| CHI Yao1, WU Qun-hong1, LI Bin2, GAO Li-jun1, LI Ye1, LIANG Li-bo1, DING Ding1, SONG Jian1, HAO Mo3 |
1. School of Public Health, Harbin Medical University, Harbin Heilongjiang 150081, China;
2. The Department of Finance, National Health and Family Planning Commission, Beijing 100044, China;
3. Research Institute of Health Development Strategies, Fudan University, Shanghai 200032, China |
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| | Abstract:Objective: To analyze the effects of essential medicine system on revenue structures at primary medical institutions. Methods:Data on revenue status and structures from 58 township health centers in Shanxi Province was collected to analyze changes and trends. Results: Along with growing government investments in primary medical institutions, the essential medicine system has fundamentally realized full coverage. The percentage of essential medicine revenue to pharmaceutical revenue rose from 20.45% in 2009 to 97.03% in 2013, though the percentage of pharmaceutical revenue to total revenue dropped by 18.43%. The percentage of fiscal subsidy revenue in total revenue rose from 25.77% in 2009 to 54.16% in 2013, though the percentage of business revenue to total revenue dropped in general. Conclusions: The essential medicine system requires the government's financial support. Essential medicine lists and primary financial aid policies should be further improved; doctor reimbursement and incentive mechanisms should be improved as well and unreasonable doctor service pricing and reimbursement mechanisms should be reformed. | |
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