摘要
目的探讨实施药品零差率对基层医疗机构收支结构的影响。方法以宁波市首批实施基本药物制度试点的某区为研究对象，收集20所基层医疗机构实施药品零差率销售前、后的收入、支出、收支结余等数据，进行分类分析。结果基层医疗机构业务收入占总收入比例，从实施药品零差率销售前的68．34％下降至实施后的65．44％，降幅为4．24％；药品收入占业务收入比例从实施前的71．68％下降至实施后的63．57％，降幅为11．31％；业务收支结余率从实施前的15．81％下降至实施后的-23．07％，降幅为245．94％；标准总工作量增加了61．77％，均次门诊病人费用、出院者人均费用分别从实施前的71．44元、2642．08元下降至实施后的48．33元、1131．28元，降幅分别为32．85％、57．18％。结论基层医疗机构业务收支亏损增大，药品收入比重偏高，应加强配套综合改革，构建刚性规范的政府投入长效机制，加强收支结构调整，建立健全合理用药体系，有效降低患者的医药费用。
Objective To probe into the influence of the zero price margin for drugs on the revenue-expenditure structure at primary healthcare organizations. Methods One of the pilot districts experimenting with this system in Ningbo city was earmarked as the research object. Within this district, the data of their revenue, expenditure and surplus were collected from 20 primary healthcare organizations prior to and after the zero price margin for drugs was in place for classification analysis. Results The percentage of service revenue among the total revenue has dropped from 68. 34% before the system was in place to 65.44% after, reducing 4.24%. The percentage of drug revenue has dropped from 71.68% before to 63.57% after, reducing 11.31%. The percentage of service surplus has dropped from 15.81% before to- 23.07% after, reducing 245.94%. The total standard workload has increased 61.77%. Average medical expense per outpatient and per inpatient has reduced 32. 85% and 57.18%, from 71.44 yuan and 2642.08 ynan before to 48. 33 yuan and 1131.28 yuan after respectively. Conclusion The deficit rise and higher percentage of drug revenue at primary healthcare organizations deserve attention.A comprehensive reform is recommended to establish a regular government financial support mechanism, further adjust the revenue-expenditure structure, set up the system of rational drug use, and effectively reduce the medical expense of patients.
出处
《中华医院管理杂志》
北大核心
2012年第5期325-328,共4页
Chinese Journal of Hospital Administration
基金
浙江省哲学社会科学规划立项课题（10CGYD52YB）
关键词
基本药物制度
基层医疗机构
收入
支出
收支结余
Essential drug system
Primary healthcare organizations
Revenue
Expenditure
Surplus
