从经济学角度看医用耗材集中采购制度带来的一些现实问题及对策

Hanzhi Gao, Yusong Hu
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摘要

医用耗材集中采购制度导致大量高值医用耗材价格断崖式下降,对公立医院的长期影响不容忽视。本文采用描述性统计和定性分析相结合的方法,从经济学的角度探讨CPSMC带来的一些现实问题。本文的研究结论如下:1)2010年以来,中国人均医疗卫生支出、人均医疗卫生支出、基本医疗保险基金支出均呈现快速增长态势。寻求更可持续的医疗耗材采购方式是大势所趋。2)医疗物资收入占公立医院医疗收入的比例逐年上升。耗材零补和集中采购制度的推广可能会对部分公立医院的盈利能力产生负面影响。3)长期以来,公立医院的中国医生收入过低。由于新冠肺炎疫情和CPS的叠加,一些医生的工资在短期内也面临着明显的下降。4)医生在长期繁重的医疗工作中得不到合理的收入补偿,可能导致工作积极性下降,医疗类型和医疗流程发生变化等负面影响。本文的结论将有助于决策部门和相关群体加深对CPS影响的全面认识和判断,完善相应的补偿机制和监管体系,促进CPS的持续健康发展。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Some Practical Problems and Solutions Caused by the Centralized Procurement System of Medical Consumables from the Perspectives of Economics
The Centralized Procurement System of Medical Consumables leads to a cliff price reduction of a large number of high-value medical consumables and has long-term impacts on public hospitals that cannot be ignored. Both descriptive statistics and qualitative analysis methods were applied in this study to explore some practical problems caused by the CPSMC from the perspective of economics. The conclusions of this study are as follows: 1) China's per capita health expenditure, per capita healthcare expenditure, and basic medical insurance fund expenditure have been growing rapidly since 2010. It is a general trend to seek a more sustainable way of medical consumables procurement. 2) The percentage of medical materials income in the medical income of public hospitals is increasing year by year. The promotion of zero makeup for consumables and the Centralized Procurement System (CPS) may have negative impacts on the profitability of some public hospitals. 3) The Chinese doctors in public hospitals have been underpaid for a long time. Due to the superposition of the COVID-19 epidemic and the CPS, the salary of some doctors are also facing a significant decline in a short term. 4) Doctors cannot get reasonable income compensation in the long-term heavy medical work, which may lead to negative impacts such as the decline of work enthusiasm and the changes of medical types and medical processes. The conclusions of this paper will help decision-making departments and relevant groups to deepen the comprehensive understanding and judgment of the impacts of the CPS, improve the corresponding compensation mechanism and regulatory system, and promote a sustainable and healthy development of the CPS.
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