中华医院管理杂志
中華醫院管理雜誌
중화의원관리잡지
CHINESE JOURNAL OF HOSPITAL ADMINISTRATION
2014年
9期
645-650
,共6页
公立医院%药品加成%补偿机制
公立醫院%藥品加成%補償機製
공립의원%약품가성%보상궤제
Public hospital%Drug addition%Compensation mechanism
目的：探讨鞍山市属医院取消药品加成后各种补偿方式及其组合的可行性。方法分析2008年至2011年鞍山市属医院医疗服务、收支状况。测算取消药品加成后医院的收支盈亏，各种补偿方式和组合对医院收支平衡、政府新增投入、医保及患者费用的影响。结果若无药品加成，医院收支盈余下降，亏损年度数倍增。对取消药品加成的损失，医疗服务价格调整或收取药事服务费可部分补偿，收取医事服务费近于完全补偿。大型设备折旧或医疗服务量财政补助亦可部分补偿，且政府财政可承受。单一方式不能完全扭转医院收支逆差，但各补偿方式组合使其亏损面明显下降。兼顾对各方的影响，医疗服务价格调整加药事服务费及医疗服务量补助的组合较优。结论实施取消药品加成政策后，建立、完善补偿机制必须充分发挥价格、医保、财政的联动作用。
目的：探討鞍山市屬醫院取消藥品加成後各種補償方式及其組閤的可行性。方法分析2008年至2011年鞍山市屬醫院醫療服務、收支狀況。測算取消藥品加成後醫院的收支盈虧，各種補償方式和組閤對醫院收支平衡、政府新增投入、醫保及患者費用的影響。結果若無藥品加成，醫院收支盈餘下降，虧損年度數倍增。對取消藥品加成的損失，醫療服務價格調整或收取藥事服務費可部分補償，收取醫事服務費近于完全補償。大型設備摺舊或醫療服務量財政補助亦可部分補償，且政府財政可承受。單一方式不能完全扭轉醫院收支逆差，但各補償方式組閤使其虧損麵明顯下降。兼顧對各方的影響，醫療服務價格調整加藥事服務費及醫療服務量補助的組閤較優。結論實施取消藥品加成政策後，建立、完善補償機製必鬚充分髮揮價格、醫保、財政的聯動作用。
목적：탐토안산시속의원취소약품가성후각충보상방식급기조합적가행성。방법분석2008년지2011년안산시속의원의료복무、수지상황。측산취소약품가성후의원적수지영우，각충보상방식화조합대의원수지평형、정부신증투입、의보급환자비용적영향。결과약무약품가성，의원수지영여하강，우손년도수배증。대취소약품가성적손실，의료복무개격조정혹수취약사복무비가부분보상，수취의사복무비근우완전보상。대형설비절구혹의료복무량재정보조역가부분보상，차정부재정가승수。단일방식불능완전뉴전의원수지역차，단각보상방식조합사기우손면명현하강。겸고대각방적영향，의료복무개격조정가약사복무비급의료복무량보조적조합교우。결론실시취소약품가성정책후，건립、완선보상궤제필수충분발휘개격、의보、재정적련동작용。
Objective To explore the feasibility of various compensation approaches and their combination after canceling the drug addition at municipal public hospitals in Anshan city.Methods 2008~201 1 medical services,balance of payments of Anshan municipal public hospitals during 2008~201 1 were analyzed,to calculate the balance of profit and loss of the hospitals with the drug addition canceled,as well as the effects of various compensation models and their combinations on hospitals’balance,government financial burden,costs of health insurance and patients’out-of-packet costs.Results Without drug addition,hospitals are found with surplus drop,and doubled number of years in deficit.Losses incurred by the canceling can be covered partly by pricing adjustment of medical services or collection of pharmaceutical service surcharge,with complete compensation by collection of medical service surcharge;government financial subsidies for large equipment depreciation or medical services offer part of the compensation,which is affordable by government finance.Such deficits cannot be covered completely by any single approach,yet they can be greatly eased by a combination of the approaches mentioned above.With impacts on all stakeholders in consideration,the optimal solution is the combination of the scheme with adjusted services price plus collection of pharmaceutical service surcharge and medical services compensation.Conclusion With the drug addition policy canceled,the establishment and perfection of the compensation mechanism calls for a synergy of pricing,health insurance and government finance.
