药价改革对医院的影响与对策

Impact of reform in drug prices on hospitals and countermeasures

国家有关部门制定了相关的管理办法和规定,对药品价格进行改革,如改变医院药品收入的会计核算方法,取消药品让利和进行大范围、大幅度的药品降价等。这对整顿药品虚高定价,扼制回扣歪风,减轻患者负担等是有积极作用的。但如果对医院补偿措施不配套、不完善,药价改革就会给医院带来如下问题:①医院的药品收入难以核定,且不利于医生安全、合理用药;②合法收入上缴,与国家有关法律不符,且可能出现会计信息不实;③药价降低,患者负担不一定降低;④药品降价造成的损失无人承担,最终落脚是在医院。针对上述问题,应采取如下对策:①加大政策宣传力度,提高认识;②从源头入手,加大打击力度,杜绝临床促销;③加强监督检查,保证药价改革政策贯彻执行;④建立一套完善的补偿机制;⑤医院内部实行全成本管理和全成本经济核算,充分调动人员积极性。

State departments concerned have formulated relevant management measures and regulations to reform drug prices, such as changing the accounting methods for hospitals drug revenues, abolishing assignment of drug profits, and undertaking large scale and substantial reduction of drug prices. These actions play a positive role in rectifying falsely high drug pricing, checking the unhealthy tendency of sales commission, and lightening the burden on patients. If there lack supporting and fairly perfect measures of compensation to hospitals, however, reform in drug prices will present the following problems to hosptials. ①Hospitals drug revenues will be hard to check as well as unfavorable to the safety of doctors and the rational use of drugs. ②Turning over to the state lawfully earned income is inconsistent with relevant state laws and may lead to false accounting information. ③Reduction of drug prices does not necessarily result in the lightening of patients burden. ④Losses resulting from the reduction of drug prices have to be sustained eventually by none other than hospitals. The following countermeasures have to be adopted accordingly. ①Further efforts must be made to publicize relevant policies so as to improve the level of understanding. ②Clinical promotion of sales must be abolished by striking at the root. ③Supervision must be reinforced so as to safeguard the implementation of policies on the reform in drug prices. ④A perfect compensation mechanism must be established. ⑤Full cost management and financial accounting must be adopted within hospitals so as to bring the staffs initiative into full play.