摘要
基层医改最主要的举措是取消"以药补医",财政补助成为乡镇卫生院最主要的补偿渠道。补偿机制的转变带来医疗机构的行为变化,例如乡村两级医疗机构药物使用有所改善;乡镇卫生院药品收入有所减少,县级医院药品收入持续增加,县域内药品销售总额仍在增加;乡村两级医疗机构服务量下降而县级医院服务量大幅增加。造成这些结果的原因有:各级医疗机构改革不同步造成的"气球效应";解决了对医疗机构的补偿,但对医生的收入分配设计不尽合理。
The main measure of primary health care reform is to cancel hospitals revenues reliance on drug sales, and financial assistance become to be the most important way of compensation mechanism. The changes of compensation mechanism are causing the changes of medical institutions behaviors, such as the drug use of township and village medical institutions has improved, the drug income of township hospitals has decreased, the drug income of county hospitals has increased, the county total drug sales has still increasing, the patient services numbers of township and village medical institutions has decline while the patient services numbers of county medical institutions has increased significantly. The reasons for these results may be： the reform of medical institutions at all levels are not synchronized, which called ＂balloon effect＂, and the compensation of medical institutions has solved but the doctor income design is not reasonable.
基金
中国卫生经济学会第十二批招标课题"新医改背景下农村医疗机构补偿机制研究(CHEA1112100202)
关键词
补偿机制
基本药物制度
收入分配制度
农村医疗机构
compensation mechanism
essential drug system
income distribution system
rural medicalinstitutions
