社区卫生服务机构实施药品零差率销售效果初评

Efficacy of Zero-Profit Drug Sales in Community Health Services Institutions

目的对南宁市社区卫生服务机构实施药品零差率销售的效果进行初步评价。方法对55家试点社区卫生服务中心(站)进行问卷调查,比较2009年3—7月及2010年3—7月的业务总收入、药品销售额、门诊量及人均门诊费用等各项指标,同时对机构相关人员进行定性访谈。结果 2010年3—7月药品销售额与2009年3—7月相比明显下降,差异均有统计学意义(P<0.05)。药品销售收入占总收入比例由51.48%下降到42.57%。门诊量及业务总收入自7月份起开始下降,人均门诊费用下降不明显。定性访谈结果显示基本目录药物品种少,与医疗保险制度衔接不尽合理未能满足群众需求。结论基本药物制度在促进药品价格下降方面效果明显,但应继续扩大基本药物品种,加强与现有医疗保险制度衔接等,以真正解决群众"看病贵"问题。

Objective To primarily evaluate the effect of Zero-Profit Drug Sales in community health institutions（CHI） of Nanning city.Methods Questionnaire survey was conducted among 55 pilot CHIs of Nanning city.The data information on gross income,drug sales income,outpatient amount,and outpatients′ fee per capita from March to July 2009 were compared with those from March to July 2010,meanwhile a qualitative interview with the relative staff of the CHIs was conducted.Results Drug sales income from March to July 2010 was decreased significantly as compared with that from March to July 2009（P0.05）,and the ratio of the drug sales income to gross income dropped from 51.48% in 2009 to 42.57% in 2010.Outpatient amount and gross income began to decline in July,but the outpatients′ fee per capita was not decreased evidently.Qualitative interview showed that varieties of drugs in national essential drugs catalog were fewer,and not matched with the medical insurance and thus the masses′ demand could not be met.Conclusion The essential drugs system is of remarkable efficacy in reducing drug price.However,the drug varieties should be further expanded so as to enhance the link to the existing medical insurance system,in order to solve the problem of overly expensive cost of medical services.