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药品收入一直是一个非常敏感的话题。 由于历史的原因,不管是大医院,还是中小医院,都存在这样一个奇怪的现象:一方面医院医疗服务亏损经营,另一方面医院依靠药品盈利。这种“堤内损失堤外补”、“以药养医”的怪圈,近几年来,一直是我国医疗体制改革最迫切也最重点的地方。 2000年卫生部《关于城镇医药卫生体制改革的指导意见》就提出具体措施:切断医疗机构和药品营销之间的直接经济利益联系,实行医药分开核算,分别管理。经过2年来的探索和实践,现状仍然是步履维艰。 今年3月,广东省试点将医院门诊药房改为药店,想在全省挑选两个城市做试点,当时竟然没有一个城市愿意挺身而出吃这个“螃蟹”!人们担心医院的补偿机制不到位;就是补偿机制到位后,又担心医疗技术劳务价格的提高,出现“两头翘”,引起老百姓的怨气。真可谓:忧心忡忡,疑虑重重。 其实,不单是广东省如此,全国的医疗机构都面临着这样的困惑:药品收入管理,路在何方?这一切能够被合理控制吗? 《当代医学》邀请了部分政府官员、医院院长、专家和学者,共同对话,探讨“医院药品收入管理”问题,希望能够为医院的院长们提供多方面的策略思考。
Revenue from medicines has always been a very sensitive topic. Due to historical reasons, there is such a strange phenomenon whether in a large hospital or a small and medium-sized hospital: on the one hand, the medical service of the hospital runs at a loss; on the other hand, the hospital relies on the profitability of drugs. In recent years, the vicious cycle of “levying levees outside levee” and “relying on medicine for recuperation” has always been the most urgent and important point for the medical system reform in our country. In 2000, the Ministry of Health’s “Guiding Opinions on the Reform of Urban Medical and Health System” put forward specific measures to cut off the direct economic interest links between medical institutions and drug marketing, and implement medical separate accounting and separate management. After two years of exploration and practice, the status quo is still struggling. In March of this year, Guangdong Province pilot changed the hospital outpatient pharmacy into a pharmacy and wanted to select two cities in the province for pilot. At that time, no city was willing to come forward and eat this “crab”! People are worried that the compensation mechanism of the hospital is not in place. After the compensation mechanism was put in place, they also worried about the increase in the price of medical and technical services, resulting in “double-headed” warring people’s grievances. Really described: worried, misgivings. Actually, it is not only the case of Guangdong Province. All the medical institutions in the country are confronted with such confusion: Where is the drug revenue management and where is the road? Can all this be controlled properly? Contemporary Medicine invited some government officials, hospital chiefs and experts And scholars, to discuss the issues of “hospital drug revenue management” in the hope of providing hospital chiefs with various strategic thinking.