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目的:探讨药品零差率政策对基层医疗机构收支结构影响。方法:以宁波市某社区卫生服务中心为对象,收集该单位实施该政策前后3年的收入、支出、收支结余等数据,进行分类比较。结果:该中心的业务收入与业务量出现上升,但其收入结构发生明显改变,药品收入占比下降(下降了4.68%),医疗收入与政府财政补助比例显著上升(分别上升了32.49%、119.07%);业务收支结余率从实施前的3.90%下降至实施后的-3.18%,下降了181.51%;均次门诊病人西药费及其占比分别下降了0.38%、9.94%。结论:基本实现“一升一降”改革政策目标,但是,社区卫生服务机构业务收支亏损增大,应加强配套综合改革,构建多渠道联动补偿机制,加强医疗行为与就医行为的监管,有效降低患者医药费用。
Objective: To explore the impact of drug zero rate policy on the revenue and expenditure structure of primary medical institutions. Methods: Taking a community health service center in Ningbo as an example, we collected data on income, expenditure, balance of payments and other expenditures of the unit before and after the implementation of the policy for classification and comparison. Results: The revenue and business volume of the center increased, but its income structure changed significantly. The proportion of medicine income dropped (down by 4.68%) and the proportion of medical income and government financial subsidy increased significantly (up by 32.49% and 119.07 respectively %). The balance of business receipts and expenditures decreased from 3.90% before implementation to -3.18% after implementation, representing a decrease of 181.51%. The western medicine expenses and its share of outpatient visits decreased by 0.38% and 9.94% respectively. CONCLUSION: The policy goal of “one liter, one drop” will be basically achieved. However, the revenue and expenditure of community health service institutions will increase. We should reinforce the comprehensive reform, construct a multi-channel linkage compensation mechanism and strengthen the supervision of medical behaviors and medical treatment , Effectively reduce the patient's medical costs.