取消药品加成对青岛市12家公立医院收入结构的影响分析

Impact analysis of medicine markups abolition on revenue structure of 12 public hospitals in Qingdao

目的分析取消药品加成、实施药品零差率对青岛市公立医院收入结构的影响。方法分析12家青岛市卫生计生委直属公立医院经济运行情况，比较改革前1年（2015年7月至2016年6月）和改革后1年（2016年7月至2017年6月）公立医院收入结构变化。结果改革后公立医院财政补助收入增加，药品收入和卫生材料收入有所减少，药占比由44．21％下降至32．71％，医疗服务收入占比和检查、化验收入占比有所上升。结论取消药品加成改革取得了一定成效，但仍存在问题，需进一步控制检查、化验等项目收入，控制中草药收入过快增长。

Objective To learn the impact of abolishing medicine markups on the revenue structure of public hospitals in Qingdao city. Methods The business performance of 12 public hospitals directly under the Qingdao Health and Family Planning Commission was analyzed to compare their revenue structure the year before （July 2015 to June 2016） and the year since the reform （July 2016 to June 2017）. Results The reform has witnessed increased government subsidies, and decreased revenue from drugs and heahhcare materials. For example, the proportion of drug expenditure decreased from 44.21% to 32.71%, while the proportion of medical service income and that of examination and laboratory examination increased to some extent. Conclusions Given the initial success of the reform, challenges remain in further curbing revenues from examinations and checkups, and growing revenue from TCM drugs as well.