摘要
运用数据模拟测算的方法,利用长江流域医院用药分析系统和全国卫生财务年报资料,分别定量分析"总额预算+按服务单元付费"组合支付方式下,3种药品替代途径及上述3者替代合计对医疗机构补偿的作用。以2008年为例,总收入不变下,在以成本价购药获得净收益增加的基础上:(1)以不同规格的同种药品替代后,全国医疗机构净收益(未计人力成本)至少可增加约1 897.9～2367.0亿元,占业务总收入的23.2-28.9%;(2)以疗效相近的同类药品替代后,净收益至少可增加约2 589.2～2 888.5亿元,占31.7%～35.3%;(3)同一大类不同亚类药品替代后,净收益至少可增加约2714.0～2982.6亿元,占33.2%～36.5%;(4)按上述3种途径组合替代后,净收益至少可增加约2536.1～2 848.5亿元,占31.0%～34.8%。以上表明:组合支付方式下,医疗机构同类药中优先使用低价药能够增加净收益。
By using the data simulation,Yangtze River Analysis System of Drugs and the National Health Financing Report data,this paper showed that：under the mixed payment of ＂Global budget and service unit＂,with the total operating revenue unchanged and on the basis of revenue from purchasing drugs by cost price,through the below three high - low - price drugs alternative behaviors respectively and the comprehensive alternative behavior,the medical institutions could get more revenue：（1） After replacing expensive drugs with cheap drugs between different specifications of the same drug,revenues could increase by at least 189.8 to 236.7 billion yuan（without considering the personnel cost） in 2008,accounting for 23.2 to 28.9 percent of total operating revenue;（2 ） After replacing between different classes of drugs of the similar efficacy,the revenues could increase by at least 258.9 to 288.9 billion yuan （accounting for 31.7 to 35.3 percent）;（3） After replacing between different sub category drugs of the similar efficacy, the revenues could increase by at least 271.4 to 298.3 billion（accounting for 33.2 to 36.5 percent）.（4） After the comprehensive high - low - price alternative behavior,the revenues could increase by at least 253.6 to 284.9 billion yuan,accounting for 31.0 to 34.8 percent of total operating revenue.In conclusion,preferring cheap drugs within the same kind could significantly increase the revenues of medical institutions.
出处
《中国卫生资源》
2011年第1期27-29,共3页
Chinese Health Resources
基金
国家自然科学基金重点项目基金资助
项目编号:70733002
"长江学者特聘教授"项目基金资助
教育部2009年度创新团队项目基金资助
项目编号:IRT0912
关键词
总额预算
按服务单元付费
医疗机构
用药行为
Global budget
Service unit
Medical institutions
Behavior of using drugs
