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目的:从县级医疗机构的收入支出情况、医院偿债能力及经营管理几个方面探讨基本药物制度的实施对县级医疗机构所产生的影响。方法:运用卫生经济学理论及医院财务分析方法对某样本市三所县级公立医院的经济运行状况进行分析。结果:基本药物制度实施以来,县级医疗机构筹资模式发生变化,药品收入对医院的补偿作用逐步减弱;部分县级医疗机构偿债能力不足,面临一定的经济运行风险;县级医疗机构的经营行为也发生明显改变。结论:明确县级医疗机构的性质和定位,强化政府责任,提高财政补偿水平;县级医疗机构应当尝试改革经济运行机制,避免经济运行风险;政府应加强对县级医疗机构的监管,规范医院经营行为。
OBJECTIVE: To explore the impact of the implementation of the basic drug system on county-level medical institutions from the aspects of income and expenditure of county-level medical institutions, solvency of hospitals and management of hospitals. Methods: Using the theory of health economics and the hospital financial analysis method to analyze the economic operation of three county-level public hospitals in a sample city. Results: Since the implementation of the basic medicine system, the mode of fund-raising in county-level medical institutions has changed, and the compensation of hospitals has been weakened gradually. Some county-level medical institutions have insufficient solvency and are facing certain risks in economic operation. The operation of county-level medical institutions Behavior also changed significantly. Conclusion: The nature and orientation of county-level medical institutions should be clarified, the government responsibility should be strengthened, and the level of financial compensation should be strengthened. County-level medical institutions should try to reform the economic operation mechanism to avoid the risk of economic operation. The government should strengthen the supervision of county-level medical institutions, Business activities.