公立医院药品零差率改革中医保基金支出分析

摘要

为破除以药养医，实行药品零差率成为公立医院改革的主要内容，改革者希望通过调整医保基金支出结构，推动公立医院破除以药养医，消除逐利性，回归公益性。本文借鉴经济学厂商理论，对医保基金支出结构变化进行理论演绎，得出医保基金支出快速增长、药品总费用不减反增、医疗服务费用支出超过预期等结论，并通过实证研究予以验证。%In order to get rid of the mechanism of drug-maintaining-medical-service, the implementation of drug- zero-profit has been the core content in public hospitals reform. Reformers hope through adjusting the structure of health insurance expenditures to promote the mechanism of drugs zero-profit, and then gradually eliminate profit-driven incentives in public hospital, and return their public service roles. Based on Theory of the Firm, we conducted a theoretical deduction on the transition of insurance fund expenditure structure, and found out that the medical insurance fund expenditures increased dramatically, the total drug costs increased rather than declined, and the health care costs were greater than expected, which have been verified through empirical studies.