上海市某社区卫生服务中心药品零差率政策的效果评价

Evaluation of Effect of Zero-Profit Drugs Policy in a Community Healthcare Service Center

目的:社区药品零差率政策实施以来,有关该政策的效果评价研究较少且评价结果褒贬不一。本文通过分析药品零差率政策的可行性和可持续性,为有效推行药品零率政策提供参考意见。方法:采用案例研究法,选取上海市某社区卫生服务中心,收集其2011-2014年信息系统中药品、费用、收支等相关数据,评价药品零差率政策的效果。结果:某社区卫生服务中心的慢性病药物种类增加6种,总额增长159.9%,抗生素类药物种类减少,2014年总额环比减少17.9%;门诊次均费增长19.5%,住院床日费用降低18.6%,药占比下降3.2%;机构药品收入比重下降至35.3%,药品支出是机构主要支出且收不抵支。结论:药品零差率政策实施后,慢性病、抗生素、输液类药品使用变化较大,药品收入比重下降但控费效果不明显,收支基本平衡但收入结构有待调查。政策推进仍需从社区卫生服务机构药品定价、补偿机制方面着手。

Objective： Though it has heen implemented nearly eight years, studies on evaluation of zero-profit drugs polieyin the community were searee aud received mixed reaction. This study aimed to verify the feasibility and sustainability of zeru-profit drugs policy so that to ellectlvely guide its practice in Shanghai and other areas.Methods：By using ease study analysis, this study evaluated the policy effects.Results： It was shown that 6 kinds of chronic drugs increased and the total volume increased by 159.9%, antibiotic drugs usage dropped and in 2014 the total amount decreased by 17.9%. Out patieut fee increased by 19.5%, hospital bed day costs deereased by 18.6%, proportion of medieine decreased by 3.2%; agency drug revenue tell to 35.3%, drug expenditure was the main expenditure of the organization and the incomes was uot supported the expenditure. Conclusion： More attention should be paid to the drag pricing, compensating mechanism.