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目的了解银川市公立医院补偿机制政策实施的效果。方法以宁夏银川市属6家公立医院为研究对象,以6家公立医院2012—2016年的运营数据,包括部分基金支出数据为基础,利用对比分析方法,通过平移,测算2016年银川市属公立医院的实际补偿率等数据,分析政策实施效果。结果 (1)自2015年取消药品加成以来,银川市属公立医院药占比明显下降,2016年政府的财政拨款在数量及对医院总收入的贡献率方面并没有由于医疗机构补偿机制的变化而有所提高。(2)以药品加成15%作为估计,2016年银川市属公立医院取消药品加成后实际综合补偿率仅为43.18%,医疗机构依然存在着政策亏损。(3)在充分考虑CPI的基础上,取消药品加成提高医疗服务价格并没有直接导致患者的医疗负担上涨。(4)医疗服务价格的上行增加了医疗保险基金的支出。结论与建议(1)加大政府的投入力度。(2)各医院进一步完善医疗服务价格的成本测算,最终形成对医疗机构的合理补偿机制。(3)提高医疗保险基金的待遇。
Objective To understand the effect of Yinchuan public hospital compensation mechanism policy implementation. Methods Six public hospitals in Yinchuan, Ningxia were selected as the research objects. Based on the operation data of six public hospitals in 2012-2016, including some fund expenditure data, by using the comparative analysis method and by translation, Hospital actual compensation rate and other data, analysis of policy implementation effect. Results (1) Since the elimination of drug additions in 2015, the share of public hospitals in Yinchuan City has dropped significantly. In 2016, the proportion of government funding allocated to hospitals and the contribution to total hospital revenue did not change due to the compensation mechanism of medical institutions And increased. (2) Taking the 15% increase of drugs as an estimation, the actual comprehensive compensation rate of the public hospitals in Yinchuan City after canceling the drug additions in 2016 was only 43.18%. The medical institutions still have policy losses. (3) On the basis of full consideration of CPI, canceling the drug addition and raising the price of medical service did not directly lead to the increase of patients’ medical burden. (4) The upward price of medical service increased the expenditure of medical insurance fund. Conclusions and Recommendations (1) Increase government investment. (2) The hospitals further consummated the cost estimation of the medical service price, and eventually formed a reasonable compensation mechanism for medical institutions. (3) improve the treatment of medical insurance fund.