上海市某社区卫生服务中心药品零差率政策的效果评价

摘要

Objective:Though it has been implemented nearly eight years,studies on evaluation of zero-profit drugs policyin the community were scarce and received mixed reaction. This study aimed to verify the feasibility and sustainability of zero-profit drugs policy so that to effectively guide its practice in Shanghai and other areas.Methods:By using case study analysis,this study evaluated the policy effects.Results:It was shown that 6 kinds of chronic drugs increased and the total volume increased by 159.9%,antibiotic drugs usage dropped and in 2014 the total amount de￣creased by 17.9%. Out patieut fee increased by 19.5%,hospital bed day costs decreased by 18.6%,proportion of medicine decreased by 3.2%;agency drug revenue fell to 35.3%,drug expenditure was the main expenditure of the organization and the incones was uot supported the expendi￣ture. Conclusion:More attention should be paid to the drug pricing,compensating mechanism.%目的：：社区药品零差率政策实施以来，有关该政策的效果评价研究较少且评价结果褒贬不一。本文通过分析药品零差率政策的可行性和可持续性，为有效推行药品零率政策提供参考意见。方法：采用案例研究法，选取上海市某社区卫生服务中心，收集其2011－2014年信息系统中药品、费用、收支等相关数据，评价药品零差率政策的效果。结果：某社区卫生服务中心的慢性病药物种类增加6种，总额增长159.9％，抗生素类药物种类减少，2014年总额环比减少17.9％；门诊次均费增长19.5％，住院床日费用降低18.6％，药占比下降3.2％；机构药品收入比重下降至35.3％，药品支出是机构主要支出且收不抵支。结论：药品零差率政策实施后，慢性病、抗生素、输液类药品使用变化较大，药品收入比重下降但控费效果不明显，收支基本平衡但收入结构有待调查。政策推进仍需从社区卫生服务机构药品定价、补偿机制方面着手。