医药分开背景下上海市公立医院补偿机制改革研究  

Research on the Compensation Mechanism Reform in Shanghai Public Hospitals under the Background of Medical-Pharmaceutical Separation

作　　者：徐嘉婕 李芬 朱碧帆 覃湫珺 金春林[1] Xu Jiajie;Li Fen;Zhu Bifan(Shanghai Health Development Research Center(Shanghai Medical Information Center),Shanghai,200040,China;不详)

机构地区：[1]上海市卫生和健康发展研究中心(上海市医学科学技术情报研究所),上海200040 [2]上海市卫生健康委员会财务管理事务中心,上海200125

出　　处：《中国卫生经济》2024年第9期35-39,共5页Chinese Health Economics

基　　金：国家卫生健康委员会体制改革司公立医院收支结构改革研究项目(2022023A)。

摘　　要：目的:梳理上海市在公立医院补偿方面的相关政策及进展,对全市公立医院的补偿情况进行现状与时间序列分析,提出完善公立医院补偿机制的政策建议,为推进公立医院高质量发展提供参考。方法:对2018—2022年上海市公立医院的收支、薪酬等数据进行横向与纵向描述性统计对比分析。结果:在取消医用耗材和药品加成、医疗服务价格调整、集中带量采购及薪酬制度改革的共同作用下,上海市公立医院收支结构逐步优化,但卫生材料收入占医疗收入比重、检查化验收入占医疗收入比重的上升,挤占了医疗服务收入的增长空间,此外医疗服务收入无法完全补偿人员经费支出。结论:建议进一步优化财政补偿方式,优化医疗服务价格调整机制,加强公立医院精细化运营管理,并完善配套支持政策。Objective:To review the relevant policies and progress of Shanghai in public hospital compensation,analyze the current situation and time series of the compensation situation of public hospitals in Shanghai,and propose policy suggestions to improve the compensation mechanism for public hospitals,so as to provide references for promoting high-quality development of public hospitals.Methods:Horizontal and longitudinal descriptive statistical analysis were conducted to compare the revenue,expenditure and salary data of public hospitals in Shanghai from 2018 to 2022.Results:Shanghai has gradually optimized the revenue and expenditure structure of public hospitals under the combined effects of removing markups on medical consumables and drugs,adjusting prices of medical services,centralizing volume-based procurement,and reforming the salary system.However,the rising proportion of medical material revenue and proportion of inspection and test revenue have occupied the growth space of medical service revenue,and the medical service income cannot fully compensate for personnel expenditure.Conclusion:It is suggested to further optimize the financial compensation method,optimize the adjustment mechanism of medical service prices,strengthen the refined operation and management of public hospitals,and improve supporting policies.

关 键 词：公立医院 补偿机制 改革成效 医药分开 上海 

分 类 号：R1-9[医药卫生—公共卫生与预防医学] R197