公立医院改革药品零差率后对药品使用的影响

Impact of drug zero-mark up sale reform on drug use in public hospital

目的:分析公立医院改革药品零差价后,医院药品使用的变化。为有关部门提供决策参考。方法:对公立医院改革前后患者负担费用指标、药品比例和药品结构三个方面的数据进行对比分析,提示药品使用趋势的变化。结果:公立医院实施药品零差率销售后,患者负担的费用指标(门诊均次费用,住院均次费用,住院床日数)均有不同程度的下降;基本药物的使用比例得到提高,自费药品比例下降;药品比例和抗菌药比例明显下降。结论:药品零差率的实施,对公立医院药品的使用比例和结构产生持久而深远的影响。

Objectives： To find out the change of drug using after implementation of ＂drug zero-mark up sale＂ in public hospital and to provide reference for relative policy makers. Method： Patients medical expense indictors, drug use ratio and medicine structure were compared before and after implementation of ＂drug zero-mark up sale＂ reform. Results： After implementation of drug zero-mark up sale reform, patients expense indictors （include outpatients average expense, the inpatients average expense and average length of stay） have been decreased in different degrees. The essential medicine use ratio has been increased and self paid drug use ratio is lower. Drug use ratio and antibiotics use ratio have been decreassed significantly. Conclusions： The implementation of drug zero-mark up sale reform has a great and long-term influence on drug use of public hospital.