实施国家基本药物制度对上海社区卫生服务中心经济补偿的影响

目的：评价实施国家基本药物制度对上海社区卫生服务中心经济补偿的影响。方法：描述国家基本药物制度实施前后上海市社区卫生服务中心经济运营状况的变化,分析运营状况发生变化的原因。结果：国家基本药物制度实施后,全市社区卫生服务中心总体运营情况由原来盈利1亿转为亏损2亿;政府投入增加了8.46亿,药品结余减少了3.19亿,医疗结余减少了7.51亿,人员支出增加了5.24亿。政府投入的增加足以弥补药品加成取消带来的损失和人员支出的增长,但医疗支出的增长速率大于医疗收入,政府投入难以弥补医疗亏损,造成社区卫生服务中心出现赤字。结论：财政投入应充分考虑医疗成本随着通货膨胀和物价上涨的增加因素,适当提高医疗卫生机构医疗服务项目的收费标准。

Effect of National Essential Drug System on Financial Compensation of Community Health Centers in Shanghai

OBJECTIVE：To evaluate the effects of national essential drug system（NEDS） on financial compensation of community health center in Shanghai.METHODS：The operation situation of community health care center was described before and after the implementation of NEDS;the reasons that caused the changes were analyzed.RESULTS：All of community health care centers had a total profit of 1 billion before the implementation of NEDS,and then had a deficit of 2 billion after the implementation.After the implementation of NEDS,the government input had increased by 8.46 billion,the balance of drug had reduced by 3.19 billion,the balance of medical service had reduced by 7.51 billion,in which the personal expenditure had increased by 5.24 billion.Due to the cancellation of drug markup rate and the escalation of human resources cost,although the government input had increased,it was still hard to cover the medical service deficit.CONCLUSION：The government should have a full consideration of the escalation of medical service cost caused by inflation and rising prices,and raise the price of medical service appropriately.