我国医药分开改革实践与国际经验借鉴
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摘要
分析了国内"以药养医"产生的历史原因,明确了实施医药分开改革的重要性。梳理2008年以来国内各省(市)推行医药分开改革的做法,并总结其成效和问题。以德国、美国、瑞典、日本为研究对象,分析其成熟的医药分业体系、医药分业模式及相应的配套措施,指出可供国内医药分开改革借鉴的经验和做法。
The history causes of drug-maintaining-medical care in China and the importance of implementing medical care and pharmacy separation reform has been analyzed. The application, effectiveness and problems of medical care and pharmacy separation reform since 2008 in China have been summarized. Taking German, America,Sweden and Japan as research objects, the medical care and drug product system, management mode and support countermeasures have been discussed to give some reference for healthcare reform in China.
The history causes of drug-maintaining-medical care in China and the importance of implementing medical care and pharmacy separation reform has been analyzed. The application, effectiveness and problems of medical care and pharmacy separation reform since 2008 in China have been summarized. Taking German, America,Sweden and Japan as research objects, the medical care and drug product system, management mode and support countermeasures have been discussed to give some reference for healthcare reform in China.
引文
[1]李志远.四川省县级公立医院取消药品加成试点改革研究[D].成都:西南交通大学,2015.
[2]康乐荣.“医药分开”现状和实施路径研究:基于几个案例的分析[D].南昌:南昌大学,2011.
[3]徐敢.公立医院医药分开路径和补偿机制系统建模研究[D].天津:天津大学,2010.
[4]杨洋.破除“以药养医”的机制初探:上海市公立医院“药品零差价”试点实证[D].上海:上海交通大学,2014.
[5]安徽省发改委.安徽基层医疗机构实施“零差率”[EB/OL].(2015-05-02)[201 8-08-23].http://www.docin.com/p-1138511637.html.
[6]杨丽英,赵志刚.德国药房概况及对我国药房的启示[J].药品评价,2012,9(26):10-14.
[7]胡保宁,罗娟,魏晓静.德日医疗保险费用控制经验的借鉴与启示[J].卫生经济研究,2013(9):25-30.
[8] Von JM. Management.of cost and utilization of pharmaceuticals in Germany[J].Health Policy,1997,41(1):45-53.
[9]唐芸霞,王旭.供方道德风险与不合理医疗费用增长控制[J].卫生经济研究,2012(8):12-15.
[10]李享,叶露.德国药品价格形成和补偿机制对我国的启示[J].中国卫生资源,2010,13(6):307-309.
[11]刘平,黄洁.中外医疗事故处理立法之比较[J].卫生经济研究,2004(10):33-34.
[12]张录法,黄丞.国外医疗卫生体系改革的四种模式[J].国际医药卫生导报,2005(11):18-22.
[13] Kane NM. Pharmaceutical cost containment and innovation in the United States[J]. Health Policy,1997,41(1):71-89.
[14]王昆.武汉市社区卫生服务实行医药分开机制的探索[D].武汉:华中科技大学,2008.
[15] Fink R. The influence of the health maintenance organization experience on medical care in the United States[J]. Bull N Y Acad Med,1984,60(5):465-478.
[16]吴激.关于医药分业问题的探讨[J].中国医院管理,1998,18(4):15-18.
[17] Wisell K, Winblad U, Sporrong SK.Reregulation of the Swedish pharmacy sector qualitative content analysis of the political rationale[J]. Health Policy,2015,59(5):648-653.
[18]山本武道.日本医药分开的过去和现在[J].中国药店,2016(3):52-54.
[19] Jeong HS. Pharmaceutical reforms:implications through comparisons of Korea and Japan[J]. Health Policy,2009,53(3):165-171.
[20]顾亚明.日本破除“以药养医”机制的借鉴:交易成本的视角[J].卫生经济研究,2014(2):19-28.
[21]李力,张卓然,王辰.日本“医药分业”介绍及启示[J].中国社会医学杂志,2014,31(2):81-83.
[22]范丽洁.医药分开在我国现状下可行策略研究[D].郑州:郑州大学,2009.
[23]龚迪和.“以药养医”体制的经济学分析[D].杭州:浙江大学,2010.
[2]康乐荣.“医药分开”现状和实施路径研究:基于几个案例的分析[D].南昌:南昌大学,2011.
[3]徐敢.公立医院医药分开路径和补偿机制系统建模研究[D].天津:天津大学,2010.
[4]杨洋.破除“以药养医”的机制初探:上海市公立医院“药品零差价”试点实证[D].上海:上海交通大学,2014.
[5]安徽省发改委.安徽基层医疗机构实施“零差率”[EB/OL].(2015-05-02)[201 8-08-23].http://www.docin.com/p-1138511637.html.
[6]杨丽英,赵志刚.德国药房概况及对我国药房的启示[J].药品评价,2012,9(26):10-14.
[7]胡保宁,罗娟,魏晓静.德日医疗保险费用控制经验的借鉴与启示[J].卫生经济研究,2013(9):25-30.
[8] Von JM. Management.of cost and utilization of pharmaceuticals in Germany[J].Health Policy,1997,41(1):45-53.
[9]唐芸霞,王旭.供方道德风险与不合理医疗费用增长控制[J].卫生经济研究,2012(8):12-15.
[10]李享,叶露.德国药品价格形成和补偿机制对我国的启示[J].中国卫生资源,2010,13(6):307-309.
[11]刘平,黄洁.中外医疗事故处理立法之比较[J].卫生经济研究,2004(10):33-34.
[12]张录法,黄丞.国外医疗卫生体系改革的四种模式[J].国际医药卫生导报,2005(11):18-22.
[13] Kane NM. Pharmaceutical cost containment and innovation in the United States[J]. Health Policy,1997,41(1):71-89.
[14]王昆.武汉市社区卫生服务实行医药分开机制的探索[D].武汉:华中科技大学,2008.
[15] Fink R. The influence of the health maintenance organization experience on medical care in the United States[J]. Bull N Y Acad Med,1984,60(5):465-478.
[16]吴激.关于医药分业问题的探讨[J].中国医院管理,1998,18(4):15-18.
[17] Wisell K, Winblad U, Sporrong SK.Reregulation of the Swedish pharmacy sector qualitative content analysis of the political rationale[J]. Health Policy,2015,59(5):648-653.
[18]山本武道.日本医药分开的过去和现在[J].中国药店,2016(3):52-54.
[19] Jeong HS. Pharmaceutical reforms:implications through comparisons of Korea and Japan[J]. Health Policy,2009,53(3):165-171.
[20]顾亚明.日本破除“以药养医”机制的借鉴:交易成本的视角[J].卫生经济研究,2014(2):19-28.
[21]李力,张卓然,王辰.日本“医药分业”介绍及启示[J].中国社会医学杂志,2014,31(2):81-83.
[22]范丽洁.医药分开在我国现状下可行策略研究[D].郑州:郑州大学,2009.
[23]龚迪和.“以药养医”体制的经济学分析[D].杭州:浙江大学,2010.