摘要
补偿机制改革是中国公立医院改革的重点。中国公立专科医院因功能定位、收入结构与综合医院存在不同，其补偿机制改革成为难点。本研究通过分析天津市某三级专科医院2013～2015年医疗收入、药品收入和财政补偿收入等数据，并模拟测算2013～2015年取消药品加成后医疗服务项目收入金额的增长额，分析样本医院的资金缺口情况，探讨当前补偿机制改革的现状和难点。本研究表明，财政补助政策和水平是决定公立专科医院补偿机制改革的决定性因素，医疗服务项目调整带来的经济补偿难以弥补公立专科医院的资金缺15，僵化的医疗服务价格调整体系亟待改革。改革带来的“次生风险”、公立专科医院的特性、提升社会效益等是改革中需考虑的重点问题。本研究提m应提高政府财政资金补助水平，建立补助资金逐步增长的长效机制：适度市场化，建立医疗服务价格动态调整机制；医疗保险体系需进行配套改革；建立完善的公立专科医院绩效评价体系；加强公立专科医院内部管理等建议，为中国公立专科医院补偿机制改革提供借鉴和参考。
Compensating mechanism reform is important in the reform of Chinese public hospitals. Because of the par- ticularities of limited medical services and income structure, compensating mechanism reform in Chinese public special hospital has been difficult. This paper based on the analysis of a public special hospital＇s medical service income, drug income and financial subsidy data from 2013 to 2015, meanwhile, simulates how much the medical service income will change during 2013-2015 after cancelled drug add, calculates the financing gap of the sample hospital, discusses the condition and difficulties of current compensating mechanism reform. The analysis shows that the level of financial subsidy policy is the key of public special hospitals compensating mechanism reform, the increased income from medi- cal service price can＇t fully make up the financial gap, rigid medical service price adjustment system need to be changed. The analysis also shows that there are several key points during the reform like ＂secondary risk＂ caused by reform, the feature of public special hospitals, promotion of social benefits. This paper puts forward the following sug- gestions： the level of government financial subsidy should be improved, and a long-term mechanism of subsidy funds gradually growth should be established; the dynamic adjustment mechanism of medical service price should be estab- lished based on the moderate marketization; medical insurance system should be innovated completely; a more com- pleted performance evaluation system of public special hospitals should be established; the internal management of public special hospitals should be strengthened. The suggestions above can provide references for compensating mecha- nism reform in public special hospitals.
出处
《中国医药导报》
CAS
2016年第21期138-141,共4页
China Medical Herald
关键词
专科医院
补偿机制
药品加成
公立医院改革
Special hospital
Compensating mechanism
Drug add
Public hospital reform
作者简介
马才辉（1989．12-），男，硕士研究生；研究方向：卫生管理。
通讯作者
