药品零差率政策实施现状分析
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摘要
目的通过对药品"零差率"政策实施现状的分析,指出实施过程中存在的问题,并针对存在的问题提出相关可行性建议,使得该政策能够真正造福于民。方法本文采用文献分析法以及资料归纳总结法,对"零差率"政策的预期成效以及目前各省市的实施现状进行分析。结果 "零差率"政策自实施以来确实取得了一些初步的成效,例如全面取消药品加成,将增加的医事服务费纳入医疗保险统筹支付,增加了医疗人员的服务价值及服务积极性;但与此同时,也有一些问题逐渐暴露出来,例如部分地区对医疗机构财政补助不足;"零差率"药品药价仍然虚高;"零差率"药品断货现象较为普遍;目录中零差率药品种类不齐全等。结论要使得药品"零差率"政策真正使患者受益,还需要各级政府部门配套政策的支持,致力于解决"零差率"政策实施过程中出现的各项问题。
Objective To analyze the current situation of the implementation of the "zero-difference" policy of the drug, point out the problems in the process of implementation, as well as to put forward relevant feasible suggestions for the existing problems,so that the policy can really benefit the people. Methods This paper uses the literature analysis method and the data summarization method to analyze the expected results of the "zero difference rate" policy and the present situation in the provinces and cities. Results The "zero-slip" policy has indeed achieved some initial results since its implementation, such as the complete abolition of drug additions, the inclusion of added medical service fees into medical insurance, the increase on the value of medical services and the enthusiasm of the service; At the same time, there are some exposed problems gradually, for example, inadequate financial subsidies in some areas of medical institutions; "Zero-rate" drug prices are still virtually high; The phenomenon of"zero-rate drug out of stock is more common; Drug classification of "zero-rate" in contents is not complete. Conclusion To make the drug "zero rate" policy really benefit the patients, supporting policies of all levels of government departments are needed, which is committed to solving the the problems during the process of "zero rate" policy implementation.
Objective To analyze the current situation of the implementation of the "zero-difference" policy of the drug, point out the problems in the process of implementation, as well as to put forward relevant feasible suggestions for the existing problems,so that the policy can really benefit the people. Methods This paper uses the literature analysis method and the data summarization method to analyze the expected results of the "zero difference rate" policy and the present situation in the provinces and cities. Results The "zero-slip" policy has indeed achieved some initial results since its implementation, such as the complete abolition of drug additions, the inclusion of added medical service fees into medical insurance, the increase on the value of medical services and the enthusiasm of the service; At the same time, there are some exposed problems gradually, for example, inadequate financial subsidies in some areas of medical institutions; "Zero-rate" drug prices are still virtually high; The phenomenon of"zero-rate drug out of stock is more common; Drug classification of "zero-rate" in contents is not complete. Conclusion To make the drug "zero rate" policy really benefit the patients, supporting policies of all levels of government departments are needed, which is committed to solving the the problems during the process of "zero rate" policy implementation.
引文
[1]张雨薇.“药品零差率”政策背景下公立医院成本补偿机制研究[D].唐山:华北理工大学, 2016.
[2]李冬美,马爱霞.基层医疗卫生机构基本药物零差率政策的实施现状分析[J].中国执业药师, 2011, 8(5):42-46.
[3]宋渝丹,何振仿,曹志辉,等.我国社区卫生服务机构药品零差率政策系统综述[J].中国卫生事业管理, 2011, 28(2):89-92.
[4]郭爽,李永平.医改新政对医药流通行业的影响及发展趋势[J].甘肃社会科学, 2008(4):42.
[5]袁达.中国新医改的伦理反思[D].长沙:湖南师范大学, 2010.
[6]各国医疗卫生支出占GDP比重[EB/OL].[2015-06-11].https://mp.weixin.qq.com/s?__biz=MzAxMDM0MzYzMw%3D%3D&idx=3&mid=211210654&sn=043f27db612b96545bf399736a8c0783.
[7]举法治之纲强民生之目[EB/OL].[2010-06-29].http://www.docin.com/p-1611869681.html.
[8]王娜,陈琦,王君丽,等.北京市药品零差率销售政策的实施对广大社区居民看病就医的影响研究[J].中国全科医学, 2011, 14(1):26-28.
[9]金萍妹.药品零差率在医院的实施及成效[J].中国总会计师,2016(4):50-52.
[10]厉李,陈瑶,姚岚,等.成都市试点社区卫生服务机构实施药品“零差率”政策的效果评价[J].中国新药杂志, 2008, 17(21):1820-1822, 1842.
[11]何振仿,丁宏,李晓峰,等.安徽省县级公立医院实施药品零差率政策效果评价[J].中国卫生事业管理, 2014, 31(8):590-592.
[12]冯英,何康玲.芜湖市公立医院实施药品“零差率”政策的效果分析[J].中国药房, 2013, 24(28):2595-2597.
[13]张崖冰,胡善联,何江江,等.上海市药品零差率政策实施效果的初步分析[J].中国卫生政策研究, 2010, 3(6):23-26.
[14]夏林兵,李永斌,王芳,等.全国重点联系城市社区卫生服务机构药品“零差率”政策施行现状及效用分析[J].中国卫生政策研究, 2010, 3(2):11-13.
[15]王铮.社区卫生服务机构药品零差率政策实施可行性研究[D].武汉:华中科技大学社会医学与卫生事业管理, 2008.
[16]高广颖,韩优莉,朱兆方,等.北京市乡镇卫生院药品零差价实施效果研究[J].中国医院, 2009, 13(7):21-25.
[17]陈铮,高军.社区药品“零差率”任重道远——冷观社区卫生服务药品集中采购和集中配送[J].首都医药, 2007, 14(5):15-19.
[18]徐俊杰,杜娟.药品费用控制与基本药物“零差率”政策的研究现状分析[J].中国医药导报, 2012, 9(23):163-165.
[2]李冬美,马爱霞.基层医疗卫生机构基本药物零差率政策的实施现状分析[J].中国执业药师, 2011, 8(5):42-46.
[3]宋渝丹,何振仿,曹志辉,等.我国社区卫生服务机构药品零差率政策系统综述[J].中国卫生事业管理, 2011, 28(2):89-92.
[4]郭爽,李永平.医改新政对医药流通行业的影响及发展趋势[J].甘肃社会科学, 2008(4):42.
[5]袁达.中国新医改的伦理反思[D].长沙:湖南师范大学, 2010.
[6]各国医疗卫生支出占GDP比重[EB/OL].[2015-06-11].https://mp.weixin.qq.com/s?__biz=MzAxMDM0MzYzMw%3D%3D&idx=3&mid=211210654&sn=043f27db612b96545bf399736a8c0783.
[7]举法治之纲强民生之目[EB/OL].[2010-06-29].http://www.docin.com/p-1611869681.html.
[8]王娜,陈琦,王君丽,等.北京市药品零差率销售政策的实施对广大社区居民看病就医的影响研究[J].中国全科医学, 2011, 14(1):26-28.
[9]金萍妹.药品零差率在医院的实施及成效[J].中国总会计师,2016(4):50-52.
[10]厉李,陈瑶,姚岚,等.成都市试点社区卫生服务机构实施药品“零差率”政策的效果评价[J].中国新药杂志, 2008, 17(21):1820-1822, 1842.
[11]何振仿,丁宏,李晓峰,等.安徽省县级公立医院实施药品零差率政策效果评价[J].中国卫生事业管理, 2014, 31(8):590-592.
[12]冯英,何康玲.芜湖市公立医院实施药品“零差率”政策的效果分析[J].中国药房, 2013, 24(28):2595-2597.
[13]张崖冰,胡善联,何江江,等.上海市药品零差率政策实施效果的初步分析[J].中国卫生政策研究, 2010, 3(6):23-26.
[14]夏林兵,李永斌,王芳,等.全国重点联系城市社区卫生服务机构药品“零差率”政策施行现状及效用分析[J].中国卫生政策研究, 2010, 3(2):11-13.
[15]王铮.社区卫生服务机构药品零差率政策实施可行性研究[D].武汉:华中科技大学社会医学与卫生事业管理, 2008.
[16]高广颖,韩优莉,朱兆方,等.北京市乡镇卫生院药品零差价实施效果研究[J].中国医院, 2009, 13(7):21-25.
[17]陈铮,高军.社区药品“零差率”任重道远——冷观社区卫生服务药品集中采购和集中配送[J].首都医药, 2007, 14(5):15-19.
[18]徐俊杰,杜娟.药品费用控制与基本药物“零差率”政策的研究现状分析[J].中国医药导报, 2012, 9(23):163-165.