中国全科医学2016，Vol.19Issue(22)：2647-2650,4.DOI:10.3969/j.issn.1007-9572.2016.22.007
基于倍差法的基本药物零差率销售对村卫生室的影响研究
Effects of Essential Drug Zero - profit Sales to Village Clinic Based on the Evaluation Method of Difference - in -difference
摘要
Abstract
Objective To analyze the effects of essential drug zero-profit sales policy on village doctors' income in village clinic,patients' medical expenses and workload in village clinic. Methods Wanglanzhuang town,Tangfang town and Nansunzhuang village,whose the number of service person and income per capita are similar,are selected as pilot township and non-pilot township of essential drug zero - profit sale. Village doctors' income, outpatient expenditure per capita, monthly outpatient amount of pilot township and non -pilot township were collected,and difference -in -difference was adopted to calculate the net change of village doctors' income,outpatient expenditure per capita,average monthly outpatient amount after essential drug zero-profit sales policy of the village clinic was carried out and hypothesis testing was conducted. Administrative staff and village doctors of health clinics in towns and townships and villagers were chosen to conduct key persons interview,the contents of which includes their feelings of the effects of essential drug zero-profit sales policy of village clinics. Results Before and after the implementation of essential drug zero-profit sales policy in pilot health clinics in villages and towns,the rate of change in village doctors'income was -45. 84%,outpatient expenditure per capita was -35. 94%,average monthly outpatient amount was 40. 14%;and before and after the implementation of essential drug zero -profit sales policy in non -pilot health clinics in villages and towns,the rate of change in village doctors' income was-1. 09%,outpatient expenditure per capita was-3. 85%,average monthly outpatient amount was -1. 56%. The results of difference-in-difference method showed that:the implementation of essential drug zero-profit sales policy resulted in 17 960 yuan decrease of village doctors' income,30. 350 yuan decrease of outpatient expenditure per capita,135. 067 people increase of average monthly outpatient amount,which was of statistical significance(P﹤0. 05). The results of interviews showed that:after the implementation of essential drug zero profit sales policy,medical expenditure of villagers decreased,but the drug types in village clinics reduced;and village doctors'income decreased,leading to theri relatively low working enthusiasm. Conclusion The implementation of essential drug zero profit sales policy reduces medical costs of villagers and improves their enthusiasm to go to the village clinics. However,at the same time the policy also imposes a large impact on the village doctors' income, which is not conducive to the healthy development of the team of village doctors. Therefore,a perfect matched compensation mechanism is desiderated.关键词
基本药物/零差率销售/村卫生室/倍差法Key words
Essential drug/Zero-profit sales/Village clinic/Method of difference-in-difference分类
医药卫生引用本文复制引用
韩彩欣,李程,李俊民,曹志辉,韩彩芬..基于倍差法的基本药物零差率销售对村卫生室的影响研究[J].中国全科医学,2016,19(22):2647-2650,4.基金项目
河北省社科基金项目（HB15GL051）；河北省科技厅项目 （）
