基本药物制度实施与乡镇卫生院补偿机制转变

Research on Implementation of the National Essential Drugs Reform and Compensation Mechanism of Township Hospitals

目的了解乡镇卫生院各项收支及药品补偿状况,探讨基本药物制度实施后,取消药品加成对乡镇卫生院的影响。方法收集华东三省49家乡镇卫生院财务及药品收支数据,对定量资料进行统计分析。结果乡镇卫生院主要的补偿渠道依然是药品收入,乡镇卫生院收入增长主要归因于增加药品收入。在财政补助收入大幅增加的情况下,乡镇卫生院对药品收入的依赖程度有所降低。结论基本药物制度的实施对乡镇卫生院的平稳运行有影响,可采取加强财政补助、建立综合补偿机制、遏制药品价格虚高等措施保证乡镇卫生院在改革中的平稳运行。

Objective To analyze the income and expenditure of township hospitals to explore the influence of basic drug system upon the development of township hospitals.Methods Analyzing financial statements of township hospitals to obtain the income and expenditure data to find out the main sources of total income.Results Drug income was still the main way of compensation for township hospitals.It is found that township hospitals were in deficit excluding drug income and expenditure,and the deficit was growing.Conclusion Financial assistance and comprehensive compensation mechanism should be established.Meanwhile,drug prices should be reduced to promote the development of township hospitals.