浙江省基层医疗机构实施基本药物制度的补偿机制研究

Compensation mechanism of basic medical institutions after implementation of essential drug system in Zhejiang province

目的:了解基层医疗卫生机构补偿机制中存在的困难和问题,并提出关于建立医疗机构合理补偿机制的意见和建议。方法:对样本县基本药物制度实施前后财务收支状况进行分析以及开展专题访谈。结果:财政补助收入金额和比例都有很大幅度的提高,药品收入占业务收入比例下降,药品加成率明显下降。补偿渠道较为单一,补偿缺乏刚性。结论:应通过强化政府责任,完善经常性收支差额核定办法,建立健全多渠道的补偿机制和构建基层医疗机构间的激励分配机制等措施来建立科学合理的补偿机制。

Objective To explore the difficulties and problems in compensation mechanism of basic medical institutions,and to put forward suggestions for establishing reasonable compensation mechanism.Methods The financial revenues and expenditures before and after the implementation of essential drug system were analyzed and specific interview was made.Results The fiscal compensation amount and ratio were improved greatly.The ratio of drug income to business income was reduced,and drug add rate was reduced greatly.The compensation approaches lacked variety and rigidity.Conclusion Measures,such as strengthening government ' s responsibility,improving checking methods of frequent payment balance,establishing various channels of compensation mechanism and incentive distribution system,should be implemented to set up a scientific and rational compensation mechanism.