刍议公立医院取消药品加成政策中的政府责任——以东莞市公立医院试点为例

ANALYSIS ON THE RESPONSIBILITY OF GOVERNMENT FROM OUTCOMES EVALUATION OF DRUG PRICE ADDITION CANCELING POLICY ON INCOMES IN DONGGUAN'S PUBLIC HOSPITAL

目的：探讨公立医院实施取消药品加成后政府的责任。方法收集某三甲医院2013年1月∽2013年9月（改革前）和2013年10月∽2014年6月（改革后）财务信息报表及药品使用资料。结果实施取消药品加成政策后该院门诊人次增长9．62％，出院人次增长3．50％，门诊次均费用下降4．69％，出院次均费用增长3．58％，群众及医务人员的满意度均未有明显提升。结论控制医疗费用取得初步成效，但政府经济补偿难以弥补医院取消药品加成而减少的合理收入。建议政府加大投入，完善考核标准及补偿方案，善用医保基金，而医院须加强内部管理。

Objective To analyze on the responsibility of government for drug price addition canceling policy on incomes . Methods We Collected the 3-A hospital financial information statements and drug use data from January 2013 to September 2013 （ before reform） and from October 2013 to June 2014 （ after reform） .Results After taking evaluation of drug price addition cance-ling policy on incomes in the hospital, outpatient visits grew 9.62%, discharges increases 3.50%, and the outpatient average com-pensation fell by 4.69% and hospitalization fees per person increase 3.58%.Conclusion Preliminary results were obtained in con-trolling health care costs, medical services in ascension.The government＆#39;s economic compensation economic compensation is difficult to make up for the cancellation of drug addition and reduce the reasonable income .It is suggested that we should improve the compen-sation scheme and assessment standards, and further strengthen the hospital internal management.