西安市社区卫生服务机构实行基本药物零差率的补偿机制研究  

Study on the Compensation Mechanism for Zero-profit of Essential Drug in Community Health Service Institutions in Xi'an,Shaanxi Province

作　　者：刘璐 杨世民[2] 方宇[2] 闫抗抗[2] 刘均[2] 

机构地区：[1]陕西省西安市卫生局,710007 [2]西安交通大学医学部药学院药事管理教研室

出　　处：《中国全科医学》2013年第1期32-35,共4页Chinese General Practice

基　　金：国家自然科学基金青年项目(71103141/G0308);中央高校基本科研业务费专项资金资助项目(2011jdhz62);西安市财政局;卫生局委托课题

摘　　要：目的探讨西安市社区卫生服务机构实行基本药物零差率补偿机制的可行性。方法截止到2010年7月西安市社区卫生服务机构共有91家,按随机抽样法抽取7家作为调研对象,采用问卷调查法和半结构式访谈法,统计药品收支等状况,并进行分析。结果 (1)问卷调查结果显示,医务人员数量平均值2007—2008年的发展速度为101.5%、2008—2009年为95.2%,药品总品种平均数3年的平均增长速度为7.8%;(2)基本药物零差率补偿金额测算显示,按照每家机构年均补偿8.2万元计,91家社区卫生服务机构年均补偿金额为746.2万元;(3)半结构式访谈结果显示,社区卫生服务机构除承担基层首诊的任务之外,还承担了众多公共卫生服务的重任,社区覆盖人口多且流动人口多,受访的社区卫生服务机构负责人普遍反映现有编制内人员无法满足工作需要。结论基本药物零差率补偿机制较为合理,但基层人员普遍担心补偿经费不足额和不到位,补偿办法尚需完善。政府部门应进一步加大社区卫生服务机构卫生经费投入,加强基本药物零差率实施各环节的综合监管,促进社区卫生服务机构落实基本药物制度。Objective To investigate the compensation mechanism for zero-profit of essential drug in community health care institutes in Xi′an. Methods A questionnaire was conducted for among a sample of randomly selected 7 out of 91 community health care institutes in Xi′an,Shanxi Province in July 2010.A semi-structured interview was also conducted to collect data related to drug revenue and expenditure. Results（1）Based on the survey results,the growth rate of average quantity of medical staff from 2007 to 2008 was 101.5%,from 2008 to 2009 was 95.2%,and the growth rate of average total drug varieties during the 3 years was 7.8%.（2）The calculation on the compensation for zero-profit of essential drugs showed that if each institution was compensated for 82 000 yuan,then a total of 7 462 000 yuan should be compensated to all the 91 health serice institutions.（3）Semi-structured interviews showed that community health service institutions not only conducted the initial diagnosis at the grassroots′ level,but also undertook various public health tasks.Given that there were many people,especially transient people in community,respondents from community health service institutions generally considered there were not enough personnel to meet the work requirements. Conclusion The compensation mechanism for zero-profit of essential drugs is reasonable,but grass-root doctors worry about the insufficient compensation and the compensation mechanism.The government should increase the budget on community health service institutions and enhance the supervision on the various links of zero-profit compensation mechanism in order to promote the implementation of basic drug policies.

关 键 词：社区卫生服务机构 基本药物 零差率 补偿机制 

分 类 号：R197[医药卫生—卫生事业管理]