重庆县级公立医院药品零差率政策对医方利益的影响及对策研究
Effects of zero-profit drug policy on hospitals’ interests in county-level public hospitals in Chongqing and the countermeasures

在公立医院综合改革的背景下，采用结构式访谈方法，对重庆市县级公立医院因实行药品零差率政 策所面临的问题及其对医院利益的影响进行探讨，并提出对策建议。药品零差率政策的初衷在于优化医院收入结 构，降低患者医疗费用。但由于补偿机制滞后，“一刀切”的药品零差率政策在一定程度上不利于县级公立医院 的发展，医院所承受的压力突出体现在财政及临床用药方面。只有加快补偿机制的改革，落实政府办医责任，建 立长效的监督机制，才能推动公立医院改革的平稳进行，实现医院回归公益性的改革目标。
Against the background of the comprehensive reform of public hospitals, we investigated the difficulties and effects of zero-profit drug policy on county-level public hospitals in Chongqing using a structured interview method, and put forward some countermeasures and suggestions. The original intention of the policy is to optimize the income structure of the hospitals and reduce the medical expenses of the patients. However, due to the lag of the compensation mechanism, the “one size fits all” trait of the zero-profit drug policy may hinder the development of county-level public hospitals to some extent. The pressure on the public hospitals is mainly from the finance and clinical drug usage. Only by speeding up the reform of compensation mechanism, fulfilling the government responsibility in medical service management, establishing a long-term monitoring mechanism, can the reform of public hospitals be carried out smoothly and deepened further so as to realize the objective of the reform—the returning of public welfare to the public hospitals