OBJECTIVE:To provide reference for the implementation of national essential medicine system.METHODS:The financial data of 20 community health service centers were collected and analyzed statistically in 2009-2011.RESULTS:The average total income in 2010 had an increase of 23.69％ over 2009,and in 2011 had an increase of 6.02％ over 2010.The average financial aid in 2010 had an increase of 92.89％ over 2009,and in 2011 had an increase of 2.80％ in 2010.The average income of medicine in 2010 had an increase of 9.14％ over 2009,and in 2011 had an increase of 24.36％ over 2010.Average income of essential medicines in 2010 had an increase of 43.15％ over 2009,and in 2011 had an increase of 75.50％ over 2010.Average cost of medicines in 2010 had an increase of 25.41％ over 2009,and in 2011 had an increase of 19.63％ over 2010.The average total balance of payments surplus from revenue dropped significantly and the loss were 257,800 yuan in 2010 and 935,500 yuan in 2011.The average total balance of payments surplus from revenue dropped to 522,800 yuan in 2011.The average number of outpatients increased first and then decreased.The outpatient costs per time increased by 28.09％ and 14.64％ over previous year.CONCLUSIONS:After the implementation of the system,in spite of significant increase of the government compensation for community health service centers,it was still insufficient; there are yet the loss of operation and "feed hospital with medical charge".The types of medicines are not able to fulfill a need of treatment.The amount of outpatient service decline while outpatient expenditure increase.It is suggested that the government should increase financial subsidies for community health service center and adjust the essential medicine list so as to meet the patient's needs and standardize the diagnosis and treatment behavior of community medical staff.%目的:为更好地推行国家基本药物制度提供参考.方法:对某市20家社区卫生服务中心2009-2011年财务报表数据进行调查、统计和分析.结果:该市20家社区卫生服务中心平均总收入2010年较2009年增加23.69％,2011年较2010年增加6.02％;平均财政补助2010年较2009年增加92.89％,2011年较2010年增加2.80％;平均药品收入2010年较2009年增加9.14％,2011年较2010年增加24.36％;平均基本药物收入2010年较2009年增加43.15％,2011年较2010年增加75.50％;平均药品支出2010年较2009年增加25.41％,2011年较2010年增加19.63％;平均总收支结余大幅下降,2010、2011年分别出现25.78万元和93.55万元的亏损,而平均药品收支结余2011年降至52.28万元;平均门诊人次表现为先降后升,而次均门诊药品费用较上一年分别增长了28.09％和14.64％.结论:实施国家基本药物制度后,该市社区卫生服务中心虽然政府财政补助明显增加,但仍补偿不足,存在亏损运营,“以药补医”现象仍有出现;药品品种数不能满足患者治疗需要;门诊服务量出现下降,而门诊费用出现上升.建议政府加大对社区卫生服务中心的财政补助,调整基本药物品种目录,使之真正满足患者治疗需要,同时进一步规范社区医务人员的诊疗行为,促进合理用药.
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