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目的:探讨基本药物制度对基层医疗机构收支结构的影响。方法:选择上海、四川和重庆地区共12所基层医疗机构作为研究对象,收集实施基本药物制度前后的收支结余等数据进行分析。结果:实施基本药物制度前后,基层医疗机构财政补助收入占总收入比例上升了20.24%,医疗收入和药品收入占业务收入的比例分别从实施前的36.86%和49.30%增长到实施后的41.68%和52.72%,增幅分别为13.09%和6.95%。收支结余率实施前后分别为-1.06%和-5.78%,降幅为-443.39%。结论:实施国家基本药物制度后,基层医疗机构医疗财政补助收入和医疗收入比重不断升高,药品比重略有下降,但多数基层医疗机构收支亏损增大。同时,基层医疗机构在服务能力和补偿等方面面临着诸多问题。
Objective: To explore the influence of essential drug system on the revenue and expenditure structure of primary medical institutions. Methods: A total of 12 grass-roots medical institutions in Shanghai, Sichuan and Chongqing were selected as research subjects. Data on the balance of payments before and after the implementation of the basic drug system were collected and analyzed. Results: Before and after the implementation of the basic medicine system, the proportion of financial subsidy income of primary medical institutions in total revenue increased by 20.24%, the proportion of medical income and pharmaceutical income in operating income increased from 36.86% and 49.30% before implementation to 41.68% after implementation, respectively And 52.72% respectively, up by 13.09% and 6.95% respectively. Before and after the implementation of the balance of payments income -1.06% and -5.78%, a decrease of -443.39%. Conclusion: After the implementation of the national essential drug system, the proportion of medical and financial subsidy income and medical income in primary medical institutions has been on the rise, while the proportion of medicines has decreased slightly, but the loss of medical expenses in most primary medical institutions has increased. At the same time, grass-roots medical institutions face many problems in service capacity and compensation.