【作者】 万伟忠；

【导师】 徐勇；

【作者基本信息】 苏州大学 ， 公共卫生， 2006， 硕士

【摘要】 目的：了解我国及国外发达国家药品费用增长情况及药品费用控制措施，探讨遏制我国药品费用过快上涨的控制措施。方法：收集中外药品费用的数据及药品费用控制措施的资料，进行比较分析。结果：通过研究发现我国药品费用增长迅速，大大超过了同期经济发展的速度，1991-1999年，药品总费用年均增长率为18.83％，人均药品费用年均增长率为17.88％；药品费用占卫生费用的比例偏高，医院药品加成收入利润率高，药品费用在医疗卫生费用中所占结构不合理，1998-2004年，卫生部门综合医院药品收入占业务收入比例从52.10％缓降至46.02％，药品收支节余总额年均增长19.25％，药品加成收入利润率从16.64％增加至31.68％：2001年我国药品费用占卫生总费用的比例为44.4％，远高于国外发达国家10-20％的比例，同时我国人均药品费用远低于国外发达国家的水平。这些问题主要是因为我国药品费用控制机制如药品价格、医院药品费用控制和药物利用等措施不完善造成的，我国现行药品费用控制措施起到了一定的作用，但通过对国外药品费用控制机制的分析比较，可以看出国外的药品费用控制措施更为系统化、综合化。结论：合适的药品价格是控制药品费用的基础，减弱药品收入与医院的补偿联系，切断药品费用与医生的直接经济联系是控制药品费用不合理增长的关键，临床合理利用药品是药品费用控制的最终目标。单一的药品费用控制措施很难实现控制药品费用不合理增长的目标，综合的、系统化措施的实施有可能实现控制药品费用的不合理增长。更多还原

【Abstract】 Objective: To know about the condition of drug expenditure increase and drug expenditure controlling measures in China and other developed countries, and explore possible controlling measures to check fast drug expenditure increase in our country.Methods: Collect, compare and analyze the date of drug expenditure and drug expenditure containment policies both of China and of foreign countries.Results: Through analysis, it is found that drug expenditure increased faster than economic development of the same period. From 1991-1999, total drug expenditure increased on average by 18.83% annually, drug expenditure per capita increased by 17.88%; drug expenditure took up a disproportionate large part of the total health cost, the rate of drug deduction of hospitals is high, the proportion of drug expenditure in total medical cost is unreasonable. From 1998-2004, statistics conducted by public health departments about income from drugs in proportion to total business income in hospitals at different levels had a slight decrease from 52.10% to 46.02%, the balance of drug cost and benefit increased on average by 19.25% annually, the rate of drug deduction increased from 16.64% to 31.68% annually; in 2001, drug expenditure to total health cost is 44.4%, much higher than 10-20% of developed countries, with drug expenditure per capita being greatly lower than that of developed countries. These problems are mainly caused by imperfect drug expenditure containment mechanisms such as drug price, hospital drug cost control and drug usage. Though the existing drug expenditure containment measures in China has had a certain effect, when compared with foreign ones, are not so systematic and comprehensive.Conclusions: Proper drug price is the basis of drug expenditure containment; weakening the relationship between income from drug and compensation to hospital and severing the direct link between drug expenditure and doctors’ income is the key to controlling unreasonable increase of drug expenditure; clinic appropriate usage of drugs is the ultimate goal of drug expenditure containment. Simple drug expenditure containment measures can’t achieve the goal of controlling the unreasonable increase of drug expenditure, while systematic, comprehensive ones can.更多还原