中新网深圳9月3日电(郑小红 李创 卜奇文)深圳市67家公立医院、569家社康中心自7月1日全面取消药品加成费用，成为全国第一个取消所有公立医院的所有药品加成的大城市。记者3日从有关部门获悉，两个月的改革摸索，基本实现了公立医院合理收入不减少，市民普遍得实惠的目标，遏制过度医疗的作用逐步显现，对倒逼医药市场规范经营管理秩序也起到了一定的作用。

Beijing on September 3, shenzhen(ZhengXiaoGong lee and reading a rare piece of ekron)Shenzhen 67 public hospital/569 club kang center since July 1st elimination drug addition cost,Be the first to cancel all public hospital drug addition all the big cities.Journalist 3 day learn from concerned branch,Two months for reform,Basic public hospitals to realize reasonable income does not reduce,Citizens have the goal of common benefit,Curb excessive medical role appeared gradually,To DaoBi medicine market to regulate management order also play a role.

临床过度用药得到遏制 Clinical excessive medication be contained

　　数据显示，两月来，全市公立医院每门诊人次费用195.9元，环比(7、8月均值与6月相比，下同)降幅2.1%；同比(与去年同期相比)降幅4.3%；其中每门诊人次药品费用74.3元，环比降幅13.0%，同比降幅11.2%。全市社康中心每门诊人次费用56.0元，环比降幅4.4%，同比降幅4.9%；其中药费26.4元，环比降幅16.7%，同比降幅21%。

Data display,Two months to,The public hospital outpatient service people each cost 195.9 yuan,link(7/August compared with the mean June,Similarly hereinafter)A drop of 2.1%;year-on-year(Compared with the same period last year)A drop of 4.3%;Each outpatient service people drug cost 74.3 yuan,Link by 13.0%,Drop 11.2% year-on-year.The club kang center each outpatient service people cost 56.0 yuan,Link by 4.4%,Drop 4.9% year-on-year;The expenses for medicine 26.4 yuan,Link by 16.7%,Drop 21% year-on-year.

　　改革后，对有深圳医保的就医人群，个人自付费用减轻了。因为医保由个人账户和统筹账户两部分组成，原来的门诊药品加成从个人账户支付，转变成诊查费后，诊查费提高部分直接从医保统筹账户支付，实际上相当于每诊疗人次个人账户支付费用减少了12元。按2011年统计口径，一年可直接减轻参保人自付费用2.09亿元。

After the reform,To have medical insurance in shenzhen the accessibility of medical care, the crowd,Individual out-of-pocket costs reduced.Because the medical insurance by individual account and as a whole account of two parts,The original outpatient drug addition from individual account pay,Into inspecting fee,Inspecting fee increase part directly from the medical insurance payment account as a whole,In fact each individual account is equivalent to the diagnosis and treatment people pay reduced 12 yuan.According to 2011 statistics caliber,A year can be directly reduce ginseng protect people out-of-pocket costs 209 million yuan.

　　遏制临床过度用药是取消药品加成制度的最主要目标。7至8月份，深圳公立医院门诊患者抗菌药物处方比例下降到13.7%(卫生部要求不超过20%，深圳市2011年11月为20.43%)；门诊静脉输液病人比例下降到8.8%(2011年8月10.9%)；药品收入占业务收入的比例(“药占比”)为32.5%，环比下降4.1个百分点，同比下降4.4个百分点。

Curb excessive use of clinical drug addition is to cancel the system of the main goal.7 to 8 months,Shenzhen public hospital clinic patients antimicrobial prescription proportion dropped to 13.7%(The ministry of health asked not to be more than 20%,Shenzhen in November 2011 to 20.43%);Outpatient intravenous infusion proportion of patients dropped to 8.8%(In August 2011, 10.9%);Drug income accounted for the proportion of business income("Medicine accounted for more than")Is 32.5%,Link fell by 4.1%,4.4% year-on-year drop.

医院业务量无明显下滑 Hospital business no significant decline

　　据统计，改革后，全市公立医院月均门急诊总量354.9万人次，同比增幅1.7%；门急诊业务收入69533.4万元，同比增幅0.7%；社康中心月均门急诊总量207.9万人次，同比增幅11.5%；门急诊业务收入11642.5万元，同比增幅6.1%。

According to the statistics,After the reform,The total amount of public hospital outpatient emergency care standard of 3.549 million people,The year-on-year growth rate of 1.7%;This business income is 695.334 million yuan,The year-on-year growth rate of 0.7%;Club kang center this standard of total 2.079 million person-time,The year-on-year growth rate of 11.5%;This business income is 116.425 million yuan,The year-on-year growth rate of 6.1%.

　　有关人士称，从改革制度设计本身来讲，诊查费增加部分完全可以抵消原来的药品加成费用。但此项改革的主要目的是遏制过度用药。医院减少了药物特别是高价药物的使用，使医院的药品收入有所减少；由于取消了加成，药品收入等于药品进价，药品收入多少与医院经济效益已经无关。通过这项改革，医院业务量没有明显下滑，也进一步拉开了医院与社康中心的诊查费收费差距，促进了市民小病到社区。

Officials say,Starting with the reform of the system in terms of design itself,Inspecting fee increase part can offset the original drug addition cost.But the main purpose of this reform is to prevent excessive medication.Hospital reduced drug especially high drug use,Make the hospital drug income has decreased;Due to the elimination of the addition,Drug income equal to drug purchase price,How much drug income and hospital economic benefit has not.Through the reform,Hospital business without apparent decline,Further to draw attention to the hospital and health center club of inspecting fee charge gap,Promote the citizen ailment to community.

　　但是，改革后，对于原来次均药品费用较高或原来平均加成率较高的医院，比如大部分市属大型医院，诊疗疑难病例多，用高价药的比例大；中医医疗机构，中药制剂原来可以按25%的比例收取加成费用。这些医疗机构的诊查费增加部分，不足以弥补药品加成的损失，但并不影响医院的正常经济运行；相反，对于大部分基层医疗机构、眼科医院、妇幼保健院等用药量小的专科医院来说，则在这次改革中增加了收入。

but,After the reform,The original second all drug cost is higher or the original average addition the higher rate of hospital,Like most under the large hospital,Diagnosis and treatment of difficult case of many,With the proportion of high medicine major;Medical institutions of traditional Chinese medicine,Traditional Chinese medicine preparation according to the proportion of 25% that can collect addition cost.These medical institutions inspecting fee increase part,Not enough to make up for the loss of the drug addition,But does not affect the normal economic operation of the hospital;instead,For most basic medical institutions/Eye hospital/Maternal and child care service centre and small specialized subject hospital patients for,In the reform, increase the income.

　　另外，7月份以来，深圳的社会药店和一些民营医院比照公立医院药品销售价格，也进行了调价。很多药品零售企业已经提前做好转型的准备，将有些药店演化为以药学服务为主的专业药房，有些药店则向多元化经营转变。

In addition,Since July,Shenzhen social pharmacy and some private hospitals in public hospital drug sales price,Has also carried on the price adjustment.A lot of drug retail enterprises have ahead of transformation of the preparation,There will be some pharmacy for the evolution of pharmacy service primarily specialized pharmacy,Some of the pharmacy is to business diversification transformation.

　　有关负责人表示，医药分开改革是一项复杂的系统工程，根本目的是切断导致公立医院提供过度医疗服务的利益纽带关系，减少民众不合理的医疗费用支出；既要让民众受惠，又要调动医院和医务人员的积极性等等。因此，要让医药分开改革取得根本的成效，促进公立医院回归公益性，促进医药卫生行业健康发展，还要完善公立医院补偿机制、调动医务人员积极性和落实其他配套改革措施。(完)

Relevant person in charge said,Medicine separate reform is a complicated system engineering,Fundamental purpose is to cut public hospital to provide excessive medical services interests ties,To reduce the unreasonable medical expenses;Should not only let people benefit,And to mobilize the enthusiasm of the hospital and medical personnel, etc.therefore,To make medical separate reform made fundamental effect,To promote public welfare public hospital regression,To promote the healthy development of the medicine industry,To perfect the compensation mechanism of public hospital/Mobilize medical staff enthusiasm and implement other supporting reform measures.(finish)