上海市社区卫生服务机构收入与支出分析

Analysis on the revenue and expenditure of community health facilities in Shanghai municipal

目的:分析上海市社区卫生服务机构的财务收支情况。资料与方法:利用上海市社区卫生服务机构的财务管理数据,进行描述性分析。结果:由于社区卫生服务的药品加成率降低、价格政策、人力成本上升等因素的综合影响,尽管政府投入逐年加大,药品收益难以补贴社区卫生机构医疗亏损,总体收支状况在2007年出现赤字。社区卫生机构经济运行仍很大程度依赖药品收入,系列改革措施在2007年还未使社区卫生机构摆脱"以药补医",政府投入责任有待进一步落实,总体运行难免出现政策性亏损。建议:为保持政策延续性,确定社区卫生机构的服务内容并核算成本;进一步明确和落实各级政府投入责任;进一步规范收支两条线管理;逐步提高反映技术劳务项目的收费价格。

Objectives： To analyze the revenue and expenditure of the community health facilities. Data and Methods ： The financial data of community health facilities are from Shanghai Municipal Health Bureau. Results ： Although the government has increased its fiscal input to community health facilities, it is hard for community health facilities to use drug benefits to cover medical service deficit in 2007 due to the combination effect of policies to control the drug markup rate, lower pricing, and the escalation of human resources cost. The community health providers still rely heavily much on drug in terms of income, and the government has not fully accomplished its commitment on input. Recommendations ： Considering the consistency of policies, we propose that first the content of service of community health facilities should be regulated and cost should be accounted, second the level of government input should be set, third the policy of dividing the revenue and expenditure should be further regulated, and finally the price of service that contains knowledge and skills be progressively raised.