药品零差价政策对医院经济运行的影响分析

Effect Analysis of Medicine Zero Spreads Policy on Hospital Economic Operation

目的分析杭州市实施药品零差价政策对其市属公立医院经济运营情况的影响程度及存在的问题。方法对市属14家公立医院实施药品零差价政策前后医院收入结构、工作量、均费水平、收支结余的变化情况进行分析。结果 2013—2015年,杭州市属公立医院纯医疗收入由21.03亿元增至38.14亿元;药占比由55.66%降至41.49%;医务人员劳务性收入占比由12.08%升至19.52%;医保均次费用得到有效控制;医疗收支结余持续下降,2015年亏损扩大到31 948万元。结论实施药品零差价政策后,杭州市属公立医院对药品收入的依赖程度降低,医院收入结构得到优化,但收支结余持续下降的问题有待进一步解决。

Objective：To analyze the effect of medicine zero spreads policy on economic operation in municipal hospitals in Hangzhou City. Method： The author made the analysis on hospital income structure, workload, average fee level, the changes in the balance of financial revenue and expenditure. Result：From 2013 to 2015 ,the pure medical income in the 14 municipal hospitals in- creased from 21.03 billion yuan to 38.14 billion yuan, drug proportion decreased from 55.66 % to 41.49 % ;labor income of medical workers changed from 12. 08% to 19. 52% ;the average expenses per times of medical insurance was effectively controlled. But bal- ance of medical payments continued to decline, the loss widened to 319,480 thousand yuan in 2015. Conclusion：After the implementation of medicine zero spreads policy, medical income dependence dropped, and hospital income structure is optimized. However, the continuous balance declination of financial revenue and expenditure remains to be further solved.