CAJ | 학술논문

目的探讨基本药物制度实施对基层医疗机构运行状况的影响.方法选取上海、江西、四川和重庆共24家基层医疗机构进行问卷调查和小组访谈,了解基层医疗机构实施基本药物制度前、后(2009年至2012年6月)的卫生服务利用情况及机构、人员的收入情况等.结果基层医疗机构的月均门急诊人次和月均住院人次上升,部分机构次均门诊费用和次均住院费用下降；药品收入比重下降,政府补助收入显著上升；基层医疗机构人员收入稳步增长,每年增长幅度保持在10％～30％之间.结论实施基本药物制度后,部分基层医疗机构出现“两升两降”,收入结构发生了重要变化.同时,绩效工资制度对医务人员的积极性起到了激励作用.
목적 탐토기본약물제도실시대기층의료궤구운행상황적영향.방법 선취상해、강서、사천화중경공24가기층의료궤구진행문권조사화소조방담,료해기층의료궤구실시기본약물제도전、후(2009년지2012년6월)적위생복무이용정황급궤구、인원적수입정황등.결과 기층의료궤구적월균문급진인차화월균주원인차상승,부분궤구차균문진비용화차균주원비용하강；약품수입비중하강,정부보조수입현저상승；기층의료궤구인원수입은보증장,매년증장폭도보지재10％～30％지간.결론 실시기본약물제도후,부분기층의료궤구출현“량승량강”,수입결구발생료중요변화.동시,적효공자제도대의무인원적적겁성기도료격려작용.
Objective To study impacts of the national essential medicine system on the operations of primary health institutions in China.Methods A total of 24 primary health institutions in Shanghai,Jiangxi,Sichuan and Chongqing were randomly sampled for a survey of questionnaire and focus group discussions.Results The average number of outpatient visits per month,average emergency visits per month,and average hospital visits per month were all higher than before.The average costs of outpatients and inpatients dropped in some institutions,and so did the proportion of drugs income.Government subsidies increased significantly and medical staff income of such institutions rose steadily.Conclusion The national essential medicine system has led to "two increases and two decreases" in such institutions,along with significant changes in the revenue makeup.Meanwhile,the pay-for-performance system proved its incentive function for medical workers at large.