公立医院破除“以药补医”机制的探讨

Discussion on problems and countermeasures of breaking “drugmaintaining-medicine” in public hospitals

破除以药补医机制是我国公立医院综合改革的关键环节,文章总结了公立医院改革试点地区在破除"以药补医",改革补偿机制方面的探索情况和成效,指出改革中存在的一些问题,如财政对医院的补偿有限,医疗服务价格调整不到位,医药利益链条并未斩断。在此基础上提出完善医疗服务价格形成机制,落实政府办医责任发挥监管作用,改革医保支付方式,加强对药品流通、销售环节的管理和监督等建议。

Breaking the mechanism of drug-maintaining-medicine is the key point of comprehensive reform in public hospitals. This study summarizes the situation and effects of breaking of drug-maintaining-medicine and compensation mechanism reform for public hospitals. We point out some problems existing in the reform, including the financial compensation for the hospital is limited ,medical service price adjustment is not enough, the chain of interests between drugs and hospitals has not been cut off. Based on such findings ,the paper suggests that the formation mechanism of medical service price should be improved, the supervising and managing responsibility of government should be cleared,the standards of medicare payment should be reformed,and management and supervision of drug distribution and sales should be strengthened.