有关药事服务费的定义及其测算方法的探讨

The definition of dispensing fee and the methods of estimation in China

目的:明确药事服务费的定义并对其进行测算。方法:通过对新医改政策的回顾、解读和国内外文献的检索,在明确药事服务费定义的基础上,采用2008年卫生部规划财务司《全国卫生财务年报资料》中的数据,分别以药品加成、药品支出减药品费和药品支出中的工资、福利支出,总门诊次数及总床日数等为目标值进行测算。结果:用上述三种方法测算得到的结果差距比较大,门诊药事服务费分别为每诊次11.42元、6.94元和3.21元,住院药事服务费分别为每床日36.75元、22.34元和10.34元。结论:对测算结果的选择取决于增设药事服务费的政策目标和政府财力。

Objective：To clarify the definition of dispensing fee and its estimation in China. Method：The paper reviews policy documents in China recent health care reform and literature retrieve of international and domestic journals. On the basis of definition of dispensing fee,the authors used the database of National Health Finance in 2008 published by the Department of Finance and Planning,Ministry of Health. The indicators used in calculation include drug mark-up,total drug expenditure and it minus drug cost and the salary,wages,and welfare fees of pharmacists in hospitals,total number of ambulatory visits and hospital bed-days. Results：The calculation is used upon three methods mentioned above. The gaps of differences are quite substantial. In term of dispensing fee in outpatient department was 11.42 Yuan,6.94 Yuan and 3.21 Yuan （RMB）,respectively. However,it in inpatient department was 36.75 Yuan,22.34 Yuan and 10.34 Yuan,respectively. Conclusion：The amount of charging dispensing fee selected from the study results is depended on policy target and government fiscal space.