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目的:为及时掌握药品零差率改革对县级公立医院业务收入与成本的影响,为相关政策的完善提供参考。方法:以某县人民医院为例,运用盈亏平衡分析法比较改革前后盈亏平衡点的工作量、业务收入、安全边际率及财政基本补助缺口,并对安全边际率进行敏感性分析。结果:“药品零差率”改革后某县级公立医院的安全边际率从改革前的-25.65%上升到改革后的-5.45%,上升了78.77%,盈亏平衡点工作量分别为2 037.24千人次与1 993.45千人次。结论:改革后医院的安全边际率有较大幅度提高,但均未达到盈亏平衡点。政府需加大财政基本补助,医院需通过增加自身工作量和控制固定成本等,改善其盈亏经营状况。
OBJECTIVE: To provide timely information on the impact of zero-turnover reform on the revenue and costs of county-level public hospitals and to provide reference for the improvement of relevant policies. Methods: A county hospital was taken as an example to compare the workload, business income, marginal rate and basic financial subsidy gap before and after the reform by using the breakeven analysis method, and sensitivity analysis of the safety marginal rate. Results: After the reform, the safety marginal rate of a county-level public hospital rose from -25.65% before the reform to -5.45% after the reform, up by 78.77%, and the workload at the breakeven point was 2 037.24 thousand person-times and 1 993.45 thousand person-time. Conclusion: After the reform, the safety margins of hospitals have been greatly improved, but they have not reached the breakeven point. The government needs to increase its basic financial subsidy. The hospital needs to improve its profit-loss operating conditions by increasing its workload and controlling fixed costs.