追求价廉质优药必然成为医疗机构的普遍购药行为:“总额预算+按服务单元付费”组合支付方式预期效果之二  

Expected effects of the mixed payment of"Global budget and Service unit"(Ⅱ):purchasing low-price and high-quality drugs will inevitably become widespread behaviors in hospitals

作　　者：吕军[1] 苌凤水[1] 王颖[1] 励晓红[1] 孙梅[1] 林尚立[2] 傅华[3] 郝模[1] 

机构地区：[1]复旦大学卫生发展战略研究中心,上海200032 [2]复旦大学国际关系与公共事务学院,上海200433 [3]复旦大学公共卫生学院,上海200032

出　　处：《中国卫生资源》2011年第1期25-26,共2页Chinese Health Resources

基　　金：国家自然科学基金重点项目基金资助;项目编号:70733002;"长江学者特聘教授"项目基金资助;教育部2009年度创新团队项目基金资助;项目编号:IRT0912

摘　　要：运用数据模拟等方法,利用全国卫生财务年报资料进行定量测算,结果显示:"总额预算+按服务单元付费"组合支付方式下,在总收入和现有用药行为不变的情况下,如果实现以成本价购药,2008年全国医疗机构净收益(未计人力成本)可增加约1 637.4～2170.5亿元,相当于业务总收入的20.0%～26.5%;即使以出厂价购药,全国医疗机构净收益至少也可增加约1142.4～1 523.2亿元,相当于业务总收入的14.0%～18.6%。表明:组合支付方式下,通过追求价廉质优药能够明显增加医疗机构净收益,起到理顺补偿机制的作用。By using the data simulation and analysis method,the National Health Financing Report data,this paper showed that;In the environment of ＂Global budget and Service unit＂ mixed payment,with the total operating revenue and the behavior of using drugs unchanged,if the hospitals could purchase all the drugs by cost price,all the hospitals nationwide could increase revenues by 163.7 to 217.1 billion yuan（without considering the personnel cost） in 2008,accounting for 20.0 to 26.5 percent of total operating revenue.Even if by ex-factory price,the revenues could increase by at least 114.2 to 152.3 billion,accounting for 14.0 to 18.6 percent of total operating revenue.In conclusion, reducing the purchasing price of drugs could significantly increase the revenues of hospitals,and can reverse the waste reimbursement mechanism.

关 键 词：总额预算 按服务单元付费 医疗机构 购药行为 

分 类 号：R197[医药卫生—卫生事业管理]