安徽省县级公立医院实施药品零差率政策效果评价

Evaluation of the Zero-profit Drug Policy Implemented in the County Public Hospitals of Anhui Province

目的：评估药品零差率政策对县级公立医院医药费用的影响。方法：以安徽省三家县级公立医院改革试点单位为典型研究现场,连续收集2012年11月~2013年4月三家医院次均门诊费、次均门诊药品费、次均住院费、次均住院药品费、门诊费用药占比、住院费用药占比六项指标值及去年同期指标值,并进行比较分析。结果：与去年同期相比：13家医院次均门诊费、次均住院费变化无明显规律;2次均门诊药品费及次均住院药品费变化无明显规律;3次均门诊费用药占比、次均住院费用药占比有所下降。结论：实施药品零差率政策后,尽管次均门诊费用药占比、次均住院费用药占比均有不同程度下降,但从控制医药费用的角度来看并未达到政策设计者期望的结果。

Objective To evaluate the impact of zero-profit drug policy on the medical cost of county public hospitals.Methods Three county public hospitals which are also known as the reforming pilot units were selected as the typical study sites,the six indexes： average outpatient fee per time,average hospitalization expenses per time,average outpatient drug expenses per time,average inpatient drug expenses per time,the drug expenses proportion in outpatient expenses,the drug expenses proportion in inpatient expenses were continuously collected from November 2012 to April 2013 and compared with the indexes collected in the same period a year before.Results Compared to the same period a year before： 1 the changes of the average outpatient fee per time and average hospitalization expenses per time seemed to follow no rules.2 the changes of average outpatient drug expenses per time,average inpatient drug expenses per time seemed to follow no rules.3the average drug proportion in outpatient expenses per time and the average drug expenses proportion in inpatient expenses per time declined.Conclusions Although the average drug proportion in outpatient expenses per time and the average drug expenses proportion in inpatient expenses per time have different levels of drop after the implementation of zero-profit drug policy,the result did not achieve the expectation of the policy designers from the perspective of controlling medical costs.