CAJ | 학술논문

目的：分析基本药物制度对基层医疗机构收入结构的影响。方法：对山西省实施基本药物制度的58家乡镇卫生院的收入状况与结构变化趋势进行分析。结果：随着政府对基层医疗机构投入的增加，基本药物制度基本实现全覆盖，基本药物收入占药品收入比重从2009年的20．45%上升到2013年97．03%，药品收入占总收入的比重下降了18．4%；与此同时，财政补助收入占总收入的比重从2009年的25．77%上升到2013年的54．16%，但业务收入占总收入比重总体呈下降趋势。结论：基本药物制度需要政府财政的大力支持，在进一步完善基层基本药物清单和基层财政补助政策的同时，完善医生薪酬和激励机制并改革不合理的医生劳务定价和补偿机制。
목적：분석기본약물제도대기층의료궤구수입결구적영향。방법：대산서성실시기본약물제도적58가향진위생원적수입상황여결구변화추세진행분석。결과：수착정부대기층의료궤구투입적증가，기본약물제도기본실현전복개，기본약물수입점약품수입비중종2009년적20．45%상승도2013년97．03%，약품수입점총수입적비중하강료18．4%；여차동시，재정보조수입점총수입적비중종2009년적25．77%상승도2013년적54．16%，단업무수입점총수입비중총체정하강추세。결론：기본약물제도수요정부재정적대력지지，재진일보완선기층기본약물청단화기층재정보조정책적동시，완선의생신수화격려궤제병개혁불합리적의생노무정개화보상궤제。
Objective:To analyze the effects of essential medicine system on revenue structures at primary med-ical institutions. Methods:Data on revenue status and structures from 58 township health centers in Shanxi Province was collected to analyze changes and trends. Results:Along with growing government investments in primary medical institutions, the essential medicine system has fundamentally realized full coverage. The percentage of essential medi-cine revenue to pharmaceutical revenue rose from 20 . 45% in 2009 to 97 . 03% in 2013 , though the percentage of pharmaceutical revenue to total revenue dropped by 18 . 43%. The percentage of fiscal subsidy revenue in total reve-nue rose from 25 . 77% in 2009 to 54 . 16% in 2013 , though the percentage of business revenue to total revenue dropped in general. Conclusions:The essential medicine system requires the government’s financial support. Essen-tial medicine lists and primary financial aid policies should be further improved;doctor reimbursement and incentive mechanisms should be improved as well and unreasonable doctor service pricing and reimbursement mechanisms should be reformed.