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一大批医院将剥离门诊药房!

2017-06-15 大鹏 “医学界”微信

今年以来,北京、成都、广州等多地的部分医疗机构开始试水药房剥离,通过医药分开倒逼医院门诊药房改革。


推进医药分开、破除以药补医是本轮医改重要举措之一。尤其是今年取消药品加成给出了最后的时间表,这就意味着,年内我国所有公立医院将全面取消药品加成,而医院门诊药房也将从利润部门变成运行成本。因此,医院药房剥离开始在不少医院实施。

那么,何谓药房剥离?为啥要把药房剥离开医院呢?

药房剥离,顾名思义,就是把医院的药房剥离开医疗机构,实行“医药分离”。至于这样做的原因,这就要追溯到2012年开始启动的公立医院改革了。

据《医学界》了解,公立医院改革启动至今,医改已然步入深水区。其中,医药分开就像一把匕首,在公立医院的“钱袋子”子上划开了一个口子。当药品加成被医事服务费所取代,当药品销售成为医院的成本支出而不是利润来源,大多数公立医院纷纷采取了类似剥离药房或者弱化药房功能的策略,以降低医院运营成本。

简言之,药品零加成之前,药房能赚钱,现在药房不仅不能赚钱,还要花医院的钱,所以要剥离!

多地医院试水药房剥离

实际上,早在今年2月份,国务院办公厅就印发了《关于进一步改革完善药品生产流通使用政策的若干意见》(以下简称《意见》)中,在进一步破除以药补医环节提到“推进医药分开。具备条件的可探索将门诊药房从医疗机构剥离。”

话音刚落,广州市妇女儿童医疗中心就宣布关闭三个院区的成人门诊药房。关闭后,病人拿医生处方可直接去院外“合作药店”取药。今后,除特殊用药外,医院的小儿门诊药房也将被药店取代。

如果再往前追溯,北京市在2015年就提出,社区医院逐步推进社区药房剥离。药品采购和供应交给商业公司处理,同时支持由第三方利用电子商务手段满足社区居民的药品需求。除北京外,成都市也已开始试点剥离社区医院药房。

对医生和医院有啥影响?

分析人士表示,逐步取消各级医院的门诊药房,让门诊患者持医生处方去药店购药,可同时实现医院、药店和患者三者共赢,这也是西方国家的经验。那么,取消门诊药房,对医院和医生会有哪些影响呢?

“一方面,取消门诊药房可降低医院的管理成本;可逐渐减少医院对药品收入的依赖,迫使医院向管理和服务要效益;另一方面,也可以减少了医院和医生收受药品回扣的机会,并能减少医生乱开药或过度用药现象。”专家表示,“这不仅可打破医院对药品零售市场的垄断,还可迅速激活药品零售市场,促使药店之间展开良性竞争,最终使药品价格合理降低。”

真的能做到医药分开了吗?

关注医改的人都知道,医药分家是必然趋势,只是先走后走一步的问题。但问题是,“取消门诊药房”就能真正做到医药分开了吗?不少业内人士对此都投了反对票。

分析人士认为,新医改以来,以药养医是造成看病贵的主要原因之一,这几乎已经成为专家的共识。在怎么破除的方法路径上,一直都在探索,但似乎到目前为止,依然没有探索出一个“一劳永逸”的办法。而现在尝试的将医院门诊药房剥离出去,短时间恐怕不能彻底解决以药养医的问题。

令人普遍担心的是,医药分离后,医院能维持下去吗?上海某医院曾经尝试对152个常规药品降价30%左右,结果,药品收入下降了3成。然而,也有专家表示,虽然药品收入下降,但医院通过加强内部控制,提供优质医疗技术与服务,从而扩大诊治规模效应,实现技术、服务性收费成为医院收入的主体,完全可以应对一部分亏损。情况究竟会如何呢?只能骑驴看唱本,走着瞧了。

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    2018-05-30 sunmin0227
  2. [GetPortalCommentsPageByObjectIdResponse(id=1654295, encodeId=eac5165429553, content=<a href='/topic/show?id=33248e580a8' target=_blank style='color:#2F92EE;'>#药房#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87580, encryptionId=33248e580a8, topicName=药房)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=878524492877, createdName=sunmin0227, createdTime=Wed May 30 15:28:00 CST 2018, time=2018-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211289, encodeId=21982112897e, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=550d2008262, createdName=luominglian113, createdTime=Fri Jun 16 00:34:44 CST 2017, time=2017-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211074, encodeId=1a872110e4ea, content=有点意思, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Thu Jun 15 10:29:40 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211067, encodeId=4b1521106e56, content=学习了很多的事情,, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NcXNhUvfhzd2dD8SUAwqrufRiaKMGaaBScoAzEicJJibuu3wCIWWQxoLgS2UOBx1vsPe3faZtAiatc0pTWlS6868zZH/0, createdBy=0a231960988, createdName=胖红, createdTime=Thu Jun 15 09:58:30 CST 2017, time=2017-06-15, status=1, ipAttribution=)]
    2017-06-16 luominglian113

    学习了,谢谢分享

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1654295, encodeId=eac5165429553, content=<a href='/topic/show?id=33248e580a8' target=_blank style='color:#2F92EE;'>#药房#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87580, encryptionId=33248e580a8, topicName=药房)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=878524492877, createdName=sunmin0227, createdTime=Wed May 30 15:28:00 CST 2018, time=2018-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211289, encodeId=21982112897e, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=550d2008262, createdName=luominglian113, createdTime=Fri Jun 16 00:34:44 CST 2017, time=2017-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211074, encodeId=1a872110e4ea, content=有点意思, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Thu Jun 15 10:29:40 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211067, encodeId=4b1521106e56, content=学习了很多的事情,, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NcXNhUvfhzd2dD8SUAwqrufRiaKMGaaBScoAzEicJJibuu3wCIWWQxoLgS2UOBx1vsPe3faZtAiatc0pTWlS6868zZH/0, createdBy=0a231960988, createdName=胖红, createdTime=Thu Jun 15 09:58:30 CST 2017, time=2017-06-15, status=1, ipAttribution=)]
    2017-06-15 戒馋,懒,贪

    有点意思

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1654295, encodeId=eac5165429553, content=<a href='/topic/show?id=33248e580a8' target=_blank style='color:#2F92EE;'>#药房#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87580, encryptionId=33248e580a8, topicName=药房)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=878524492877, createdName=sunmin0227, createdTime=Wed May 30 15:28:00 CST 2018, time=2018-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211289, encodeId=21982112897e, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=550d2008262, createdName=luominglian113, createdTime=Fri Jun 16 00:34:44 CST 2017, time=2017-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211074, encodeId=1a872110e4ea, content=有点意思, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Thu Jun 15 10:29:40 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211067, encodeId=4b1521106e56, content=学习了很多的事情,, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NcXNhUvfhzd2dD8SUAwqrufRiaKMGaaBScoAzEicJJibuu3wCIWWQxoLgS2UOBx1vsPe3faZtAiatc0pTWlS6868zZH/0, createdBy=0a231960988, createdName=胖红, createdTime=Thu Jun 15 09:58:30 CST 2017, time=2017-06-15, status=1, ipAttribution=)]
    2017-06-15 胖红

    学习了很多的事情,

    0

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接下来 一大批医院将剥离门诊药房

关注医改的人都应该知道,医药分家是必然趋势,只是先走后走一步的问题。但问题是,“取消门诊药房”就能真正做到医药分开了吗?

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