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目的:探讨实施药品零差率对公立中医医院收支结构的影响。方法:以某市6所县级公立中医院为研究对象,收集样本中医院药品零差率前后的收入、支出、收支结余等数据,进行分类分析。结果:样本中医院药品零差率前后均以药品收入为主,医技收入占医疗收入比例从实施前的35.13%上升到实施后的43.88%,增长了24.91%;药品收入占医疗收入比例从实施前64.87%下降到实施后56.12%,下降了13.49%;业务收支结余率从实施前-0.47%上升至实施后的6.56%,增长了1 483.19%;均次门急诊病人药品费、均次住院床日药品费、出院者人均药品费用同期分别下降了2.02%、10.78%、19.89%。结论:加强配套综合改革,强化政府投入责任,建立健全中医医疗服务价格动态调整机制,适度控制中药饮片加成率,构建符合中医药服务特点的新型分类补偿机制。
Objective: To explore the impact of the implementation of drug zero rate on the revenue and expenditure structure of public hospitals. Methods: Six prefectural-level public hospitals in a city were selected as research objects to collect the data of income, expenditure, income and expenditure balance before and after the drug zero-difference rate in the sample hospitals for classification analysis. Results: Before and after the drug zero-slip rate in the sample hospitals were all based on the drug income, the proportion of medical income to medical income increased from 35.13% before implementation to 43.88% after the implementation, an increase of 24.91%; the proportion of medical income to medical income increased from From 64.87% before implementation to 56.12% after implementation, down by 13.49%; the balance of business receipts and expenditures rose from -0.47% to 6.56% after the implementation, an increase of 1 483.19%; the average outpatient and emergency patient drug costs were On the other hand, the cost of hospital bed drug per day, per capita drug costs for discharged persons decreased by 2.02%, 10.78% and 19.89% respectively over the same period. Conclusions: We need to reinforce the comprehensive reform, strengthen the responsibility of government investment, establish and improve the dynamic adjustment mechanism of TCM medical service prices, moderately control the additive rate of TCM Pieces, and construct a new classification compensation mechanism in line with the characteristics of traditional Chinese medicine services.