浙江省基本药物制度实施后基层医疗机构补偿现状分析

Compensation status quo of basic medical institutions after implementation of national essential drug system in Zhejiang province

目的:了解浙江省实施基本药物制度后,基层医疗机构的收入构成变化情况及政府补偿现状,分析补偿机制中存在的问题。方法:查阅基本药物实施相关补偿政策文件并对相关财政补偿情况月报表进行统计分析。结果:经济发达地区补偿水平远高于经济中等和经济欠发达地区,基层医疗机构累计总收入有一定的下降,财政补偿只占药品总收入累计减少额的75.91%。结论:浙江省财政补偿方法主要是收支差额核定,财政补偿水平存在明显地区差异且财政补偿难以足额到位,基层医疗机构发展受影响。

Objective To understand the compensation status quo and change of income structure of basic medical institutions after implementation of essential drug system in Zhejiang Province. Methods Policy documents about compensation of essential drug system were reviewed and fiscal compensation monthly reports were statistically analyzed. Re- sults Compensation level of developed area was higher than that of average developed areas and underdeveloped areas. The accumulative gross incomes of basic medical institutions were decreased to some extent. The fiscal compensation accounted for 75.91 % of the total reduced amount of drugs. Conclusion The payment balance checking is the main compensation method. The fiscal compensation level has a significant regional difference and is difficult in full quota,which affects the development of basic medical institutions.