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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。
Objective: To evaluate the impact of the implementation of the national essential drug system on the economic compensation of Shanghai Community Health Service Center. Methods: Describe the changes of economic operation status of community health centers in Shanghai before and after the implementation of the national essential drug system, and analyze the reasons for the changes in the operating conditions. Results: After the implementation of the national essential drug system, the overall operation of the community health service center in the city shifted from a profit of 100 million yuan to a loss of 200 million yuan; the government investment increased by 846 million yuan, the balance of medicines decreased by 319 million yuan, the medical balance decreased by 751 million yuan, and the staff Expenditure increased by 524 million. The increase in government investment is sufficient to make up for the loss caused by the abolition of drug additions and the increase in personnel expenses. However, the growth rate of medical expenditure is greater than the medical income, and the government investment can hardly make up for the medical loss, resulting in a deficit in the community health service center. Conclusion: The financial input should fully consider the medical cost. With the increase of inflation and rising price, the standard of medical service should be appropriately increased.