国内外设立药事服务费理论与策略研究进展 - 中国循证医学杂志.pdfVIP

Original Articles Chin J Evid-based Med 2011, 11(8): 868-872 国内外设立药事服务费理论与策略研究进展 1 1 2 2 郑小华  胡锦梁  张连帅  陈  姗 1. 四川省医学科学院•四川省人民医院（成都 610072 ）；2. 成都中医药大学公共卫生与管理学院（成都 610075 ） 摘要  目的 了解国内外药事服务费的设立基础与现状，明确药事服务的范围，为我国药事服务费的设立与 实施提供参考。方法 遵循循证医学原则，采用描述性分析方法，阐述药事服务费设立的基础，并比较国内外药 事服务费的不同定义及收取方式与测算标准的差异。结果 药事服务费设立的基础是医药分业，在西方国家，尽 管各国对药师服务费的定义和界定范围不同，但其收费标准却大同小异。相对于根据处方价格、处方上药品种类 数量和处方上药品类型为收费测算基础而言，按就诊次数确定药事服务费较为合理。结论 我国药事服务费测算 应以处方费、药品管理和储存成本为基础。药事服务费应先在试点医院实施，在基层医疗服务机构实施收支两条 线的情况下，可不实施药事服务费。在城市大医院，在推进医药分开管理的同时逐步推行医药分业，发挥药剂师 对处方的审核、调配和咨询作用。对零售药房，要逐步配齐药剂师，并将其作为药房经营许可的必要条件之一。应 开展药剂师服务和药事管理的绩效评价。 关键词 药事服务费；公立医院补偿；取消药品加成政策；医药分业；收费策略 Study Progress of Theories and Strategies on Setting up the Dispensing Fee at Home and Abroad 1 1 2 2 ZHENG Xiao-hua , HU Jin-liang , ZHANG Lian-shuai , CHEN Shan 1. Sichuan Medical Science Academy Sichuan People’s Hospital, Chengdu 610072, China; 2. School of Management of Chengdu University of TCM, Chengdu 610075, China Abstract Objective To understand the basis and status of setting up the dispensing fee at home and abroad, and to ascertain the scope of dispensing service, so as to offer references to the setting up and implement of dispensing fee in China. Methods According to the evidence-based principle, the descriptive method was adopted to demonstrate the basis of setting up the dispensing fee. The different definition, payment mode and standard were compared at home and abroad. Results Separation of prescribing and dispensing was the basis of setting up the dispensing fee. In western countries, the charge of dispensing fee was almost at the same level, though its definition and scope were different among countries. It was more reasonable to determine the level of dispensing fee according to the visiting frequency, compared with the price,