公立医院医药分开改革的经济学分析

Economic analysis on separation of clinic from pharmacy in public hospitals

"看病难、看病贵"是中国医疗体制面临的一个重要问题,其中"以药养医"是导致"看病贵"的主要原因。为此,新医改逐步取消了药品加成,但一直面临着能否从根本上解决"看病贵"问题的质疑,公立医院收入补偿来源的问题也值得探讨。针对以上两个问题,本研究试图运用微观经济学理论,建立关于医院和患者的医药供需均衡模型,根据模型结果对其展开讨论。医药分开后,药品均衡数量减少,均衡价格降低,社会用药总支出减少,并且医疗保险政策的介入使上述效果更明显。通过研究得出以下结论:医药分开是破除"以药养医"的关键,在一定程度上缓解了"看病贵"的问题,但并不能从根本上解决"看病贵"问题。坚持医保的主导地位,深化医保付费方式改革是解决"看病贵"问题的根本,也是完善公立医院补偿机制的核心。

The difficulty and high cost of getting medical treatment is an important issue facing China＇s medical treatment,in which ＂supporting medicine with drugs＂ is the main reason leading to ＂expensive medical treatment＂. For this reason, in the new medical reform trial situation it gradually abolished drug additions ,however, it has been facing the question of whether to solve the problem of ＂expensive medical treatment＂ fundamentally, the issue of public hospital income sources of compensa- tion is also worth exploring. In view of the above two problems,the analysis attempts to use the microeconomics theory to es- tablish a balanced model of supply and demand of medicine between hospitals and patients, and then discusses it. After sepa- ration of clinic from pharmacy the balance of drugs, the equilibrium price and the total expenditure on social medicine have been reduced. The intervention of the medical insurance policy makes the above-mentioned effects more obvious. Through the research, the following main conclusions are obtained：the separation of medicine is the key to getting rid of ＂medicine to support medicine＂, to a certain extent, alleviated the problem of ＂expensive medical treatment＂. But it cannot fundamentally solve the problem of ＂expensive medical treatment＂. Adhere to the dominance of health insurance and deepening the reform of medicare payment method is the fundamental solution to the problem of ＂expensive medical treatment＂ and the core of public hospital compensation.