收支两条线管理对公立医疗机构经济运行的影响分析

Investigation the influence of separation of revenue and expenditure on economic operation in public medical institutions

目的:了解收支两条线管理实施前后上海市松江区公立医疗机构经济运行情况。方法:采用收集公立医疗机构财务报表,再由松江区卫生局统一填写自行设计调查表的方法开展调查。结果:收支两条线管理实施后,上海市松江区公立医疗机构财政补助收入和门急诊人次数逐年增加,业务收入占比和每门急诊人次费用明显下降,但公用支出居高不下,且医疗服务收支赤字持续存在。结论:收支两条线管理保证了公立医疗机构的良好发展,并且促进了其公益性的回归,这种政府为主导的卫生投入机制使基本药物制度的实施有了可能,但公立医疗机构仍需加强预算管理、控制运行成本。

Objective： To learn the economic performance of public medical institutions in Songjiang district of Shanghai before and after the separation of revenue and expenditure. Methods： Financial statements of public medical institutions were collected, and the designed questionnaires were filled by district health bureau. Resttlts： After the implementation of separation of revenue and expenditure,public medical institutions in Songjiang district had not only gained steadily increase of financial assistance, out-patients and emergency patients, but also realized signifieanty deereasined percent of operating income and expense per out-patient or emergency patient. However,public spending remained at high level and financial deficit of medical service still existed. Conclusion： Separation of revenue and expenditure,which is a kind of government-dominating health investment mechanism, has ensured good development of public medical institutions, facilitated its return to commonweal, and made it possible for implementation of basic drug system. However, public medical institutions should strengthen budget management and control operating cost.