基本药物制度对4省市基层医疗机构运行状况的影响  

Impact of the national essential medicine system upon operations of prinmry health institutions： an empirical study in four provinces and cities

作　　者：姚岚[1] 姚强[1] 许速 贾立明[3] 周军[4] 邓莉 韩德辉 蔡霓 刘智勇[1] 

机构地区：[1]华中科技大学同济医学院医药卫生管理学院,武汉430030 [2]上海市闵行区卫生局 [3]江西省卫生厅药政处 [4]四川省卫生厅药政处 [5]重庆市卫生局药政处 [6]中国医疗健康信息学院

出　　处：《中华医院管理杂志》2013年第5期338-343,共6页Chinese Journal of Hospital Administration

基　　金：艾美仕（IMS）中国医疗健康信息学院资助项目（2011001）

摘　　要：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。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.

关 键 词：基本药物制度 基层医疗机构 卫生服务 财政结构 影响 

分 类 号：R95[医药卫生—药学]