消除药品生产、流通、购买、使用“一条龙”的混乱现象:“总额预算+按服务单元付费”组合支付方式预期效果之三  

Expected effects of the mixed payment of"Global budget and Service unit"(Ⅲ):eliminating the disorder of production,distribution,purchasing,using in pharmaceutical market

作　　者：杜蕾[1] 孙梅[2] 王颖[2] 苌凤水[2] 励晓红[2] 吕军[2] 马安宁[3] 屈卫东[4] 郝模[2] 

机构地区：[1]上海市食品药品监管局科技情报研究所,上海200233 [2]复旦大学卫生发展战略研究中心,上海200032 [3]潍坊医学院,山东潍坊261042 [4]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30-32,共3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：基于支付方式设计原理,结合医疗卫生服务管理者、组织者、提供者的意向调查数据,论证了"总额预算+按服务单元付费"组合支付方式对消除药品生产、流通、购买、使用一条龙乱象,促进药品市场有序发展的效果,文章认为:通过支付方式改变,医疗机构的补偿由原来的"多开药、多开贵药"转变为"少开药、少开贵药",药品市场导向由此由高价药易销转变为价廉质优药易销,因此能够消除药厂低水平重复建设、百业经营药品等畸形景象,发改委(计委)多年追求的解决药品企业"低水平重复建设"问题水到渠成;老百姓能够吃上质优价廉药;药品质量监管成为重点,也为基本药物目录制度、医药分业等改革措施提供了充要条件。Based on the design principle of payment and the intention survey of health service managers,organizers, providers,this paper demonstrated that the ＂Global budget and Service unit＂ mixed payment could eliminate the disorder of production,distribution,purchasing,and using in drug market and could facilitate a well -regulated development of drug market. With the payment changing,the reimbursement of hospitals was reversed from ＂more prescription drugs,more expensive drugs＂ to ＂less prescription drugs,less expensive drugs＂,the connection between hospital revenue and drugs was blocked,the phenomenon ＂drug - maintaining - medical service＂ was eliminated.Meanwhile,the orientation of the drug market changed from ＂expensive drugs sell well＂ into ＂low -price and high -quality drugs sell well＂.The phenomena,such as repeating construction of low - level pharmaceutical factories and operating pharmaceutical circulation enterprises in every line of business, were removed.Thus,the issue of ＂repeating construction of low -level pharmaceutical factories＂could be solved as the wishes of Development Reform Commission.Common people could get high - quality and low - price drugs,the drug quality would become a key target of supervision.All the expected effects above would supply adequate conditions for innovations such as the national essential medicine system,separation between medical service and hospital pharmacy,etc.

关 键 词：总额预算 按服务单元付费 药品市场 

分 类 号：R197[医药卫生—卫生事业管理]