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目的:了解基层医疗卫生机构补偿机制中存在的困难和问题,并提出关于建立医疗机构合理补偿机制的意见和建议。方法:对样本县基本药物制度实施前后财务收支状况进行分析以及开展专题访谈。结果:财政补助收入金额和比例都有很大幅度的提高,药品收入占业务收入比例下降,药品加成率明显下降。补偿渠道较为单一,补偿缺乏刚性。结论:应通过强化政府责任,完善经常性收支差额核定办法,建立健全多渠道的补偿机制和构建基层医疗机构间的激励分配机制等措施来建立科学合理的补偿机制。
Objective: To understand the difficulties and problems in the compensation mechanism of primary medical and health institutions and to put forward opinions and suggestions on establishing a reasonable compensation mechanism for medical institutions. Methods: The analysis of the financial balance before and after the implementation of the basic medicine system in the sample counties and the special interviews were conducted. Results: Both the amount and the proportion of financial subsidy income increased greatly. The proportion of revenue from pharmaceuticals in the business income dropped and the rate of increase in drugs dropped markedly. The compensation channels are relatively simple and the compensation lacks rigidity. Conclusion: It is necessary to establish a scientific and reasonable compensation mechanism by strengthening government responsibilities, perfecting the verification method of recurrent receipts and payments balance, establishing and improving a multi-channel compensation mechanism and establishing an incentive distribution mechanism among grass-roots medical institutions.