实施基本药物制度对基层医院运行的影响分析

Impact of the essential drug list on the grassroots health care facilities

通过分析实施基本药物制度对基层医院运行的影响,认为基层医院硬件水平在提升,但是对病人吸引力在下降;基本医疗服务绝对量增加,但是相对量下降,盈利能力下降;财政拨款增加,但是占业务收入的比例先升后降;人员技术水平较低,难以实行绩效工资;药品收入仍是医院收入的主要来源;工资福利支出增长最快。分析原因,主要是基层对基本药物制度认识不到位,补助不到位且没有因地制宜,基本药物目录和医保用药目录差异较大,基层医院基本药物改革单兵突进。

The equipment and building in grassroots hospital was improved and its attraction for patients was reduced after the essential drug list. The number of primary health services increased and the profits reduced. The government subsidy increased and its proportion among total income increased first and then dropped. Performance based salary failed because of poor medical skills in grassroots facilities. Drug sale was still the main hospital income. The expenditure of salary and staff welfare increased most quickly. The reasons included failing to understand the essential drug list, insufficient government subsidy, the big discrepancy between the essential drug list and health insurance list, and focusing solely on the grassroots hospital reform.