【摘要】：近年來,我國以藥養(yǎng)醫(yī)的醫(yī)療體制造成醫(yī)藥價格不合理、過度醫(yī)療以及醫(yī)藥界的腐敗等諸多問題,使得“看病難,看病貴”的矛盾凸顯,醫(yī)患關系緊張。為解決以藥養(yǎng)醫(yī)的弊端,自1998年來我國開始著手研究醫(yī)藥分開的相關政策,并在各地推廣醫(yī)藥分開改革的試點,先后嘗試了收支兩條線模式、藥房分離模式、以及取消藥品加成的模式,試圖切斷醫(yī)藥間的利益關系,消除醫(yī)療機構(gòu)對于藥品的依賴。本文通過對醫(yī)藥分開各階段政策的梳理以及對現(xiàn)行醫(yī)藥分開三種模式的分析,借鑒國外醫(yī)藥分開的經(jīng)驗及教訓,探討醫(yī)藥分開的必要性、理想化醫(yī)藥分開的途徑,以及如何通過財政政策引導醫(yī)藥分開改革。 論文首先對醫(yī)藥分開的概念、研究背景、研究意義以及醫(yī)藥分開必要性進行分析。對以藥養(yǎng)醫(yī)的形成、發(fā)展以及醫(yī)藥分開的政策進行梳理,分析了我國從以藥養(yǎng)醫(yī)到醫(yī)藥分開的政策變化以及以藥養(yǎng)醫(yī)的弊端。 其次,論文對我國現(xiàn)行的三種醫(yī)藥分開方案及其實施效果進行了分析和研究,發(fā)現(xiàn)雖然我國現(xiàn)行的醫(yī)藥分開改革對于切斷醫(yī)藥間的利益關系以及降低醫(yī)療費用起到了一定的作用,但是三種模式均存在著缺陷,從而未能改變醫(yī)療機構(gòu)對于藥品的依賴。 在借鑒與我國醫(yī)療體制形式相近的日、韓兩國的醫(yī)藥分開改革經(jīng)驗的基礎上提出了對我國醫(yī)藥分開改革的思考。要想真正做到醫(yī)藥分開,就必須實現(xiàn)醫(yī)藥在收支核算、實物流通、補償機制這三個方面的分開,從而改變醫(yī)藥間的利益分配結(jié)構(gòu),理順醫(yī)藥關系,促使醫(yī)藥體制良性發(fā)展。最后,論文建議通過加大財政投入、改變財政支付方式、完善醫(yī)療保障制度以及利用稅收調(diào)節(jié)等財政政策,引導醫(yī)藥分開政策的順利實施。
[Abstract]:In recent years, the medical system of raising medicine with medicine in our country has caused many problems, such as unreasonable price of medicine, excessive medical treatment and corruption in medical field, which makes the contradiction of "difficult to see a doctor, expensive to see a doctor" prominent, and the relationship between doctors and patients is tense. In order to solve the problem of raising medicine with drugs, since 1998, our country has begun to study the related policies of separation of medicine and medicine, and has promoted the pilot reform of separation of medicine and medicine in various places, and has tried the two line pattern of revenue and expenditure and the mode of separation of pharmacy successively. It also tries to cut off the relationship between medical interests and eliminate the dependence of medical institutions on drugs. This paper discusses the necessity of the separation of medicine from medicine and the way of idealizing the separation of medicine by combing the policies of different stages of separation of medicine and analyzing the three models of separation of medicine and medicine currently in force, and drawing lessons from the experience and lessons of the separation of medicine from foreign countries. And how to guide the reform of medicine through fiscal policy. This paper first analyzes the concept, research background, significance and necessity of medical separation. In this paper, the formation, development and the policy of separating medicine from medicine to medicine are analyzed, and the change of policy from medicine to medicine is analyzed, and the malpractice of keeping medicine with medicine is also analyzed. Secondly, the thesis analyzes and studies the current three schemes of separation of medicine and medicine in our country and the effect of their implementation. It is found that although the current reform of separated medicine in our country has played a certain role in cutting off the relationship between the interests of medicine and reducing the medical cost, the three models all have defects, thus failing to change the dependence of medical institutions on drugs. Based on the experience of medical separation reform in Korea and Japan, this paper puts forward some thoughts on the reform of medicine separation in China. In order to realize the separation of medicine and medicine, it is necessary to realize the separation of income and expenditure accounting, material circulation and compensation mechanism, so as to change the distribution structure of benefits between medicines, straighten out the relationship between medicine and medicine, and promote the healthy development of medicine system. Finally, the paper proposes to guide the smooth implementation of the separation of medicine policy by increasing the financial input, changing the way of financial payment, perfecting the medical security system and utilizing tax regulation and other financial policies.
【學位授予單位】：首都經(jīng)濟貿(mào)易大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R197.1;F812.0

【引證文獻】

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本文編號：2416428