药品零差率对贵州省城市公立医院运营的影响

The influence of zero-profit drug sales in urban public hospital operation of Guizhou Province

[目的]分析贵州省城市公立医院药品零差率政策的实施效果及其影响。[方法]通过贵州省卫健委收集2014-2018年全省57家城市公立医院的卫生统计年报资料,对公立医院的经济运营情况进行统计描述。[结果]实施药品零差率销售以来,贵州省城市公立医院各项收支均稳步增加,财政补助由2014年的11.43亿元(6.90%)增加到2018年的22.06亿元(7.59%),自2014年以来,药品收入逐年增长但占比偏低,药品占比逐年下降;门诊次均医疗费用有所增加。[结论]实施药品零差率政策以来,贵州省城市公立医院各项收入有所增长,患者次均费用未降低,医疗服务价格机制未有效运转。

Objective To analyze the implementation effect and influence of zero-profit drug sales policy in urban public hospitals in Guizhou Province. Methods Collected health statistics annual report of 57 urban public hospitals in Guizhou from 2014 to 2018 through the Health Commission of Guizhou Province,and made statistical descriptions on the operations of public hospitals. Results Since the implementation of zero-profit drug sales policy,revenue and expenditure of urban public hospitals in Guizhou Province were increasing steadily,government subsidies increased from 1. 143( 6. 90%) in 2014 to 2. 206 billion yuan( 7. 59%) in 2018. From 2014,drug income is increasing year by year,but the proportion was low,the proportion of drug was declining year by year. The average drug cost of outpatient service and hospitalization decreased obviously,but the average medical expenses of outpatient service increased. Conclusions Since the implementation of zero-profit drug sales policy,revenue of urban public hospital increase somewhat in Guizhou. The average cost of patient has not decreased. The pricing mechanism of medical service has not effectively operate.