基于企业边界理论的医药分开思考.PDF

□□政策研究 《中国卫生经济》第35 卷第3 期 （总第397 期）2016 年3 月 基于企业边界理论的医药分开思考* ① ② 李 静 ，武 锋 摘 要 目的：分析医药分开的影响因素，探索医药分开的改革措施。方法：借鉴企业边界理论研究医院与药房的关 系。结果：目前我国医药不分的主要因素是处方的捆绑式销售和大型集中式门诊。结论：通过改革医疗保险制度，促进处方 流动以降低医院药房的收入，同时采取征收营业税等手段增加医院药房的运营成本，促进医院放弃药房，最终实现医药分开。 关键词 企业边界理论；医药分开；处方流动 中图分类号R1-9 ；R19-0 文献标志码C 文章编号1003-0743(2016)03-0031-03 DOI 10.7664/CH StudyonSeparationofPrescriptionandDispensingBasedonEnterpriseBoundaryTheory/LIJing,WUFeng//Chinese HealthEconomics，2016，35(3):31-33 Abstract Objective: To analyze influencing factors for the separation of prescription and dispensing and explore measures for promoting separation of hospitals and pharmacies. Methods: Analyzing relationship between hospitals and pharmacies by using enter⁃ prise boundary theory. Results: In China, the main factors for the separation of prescription and dispensing were the bounded sales of medicine and pharmacy services and huge centralized outpatients department of hospitals. Conclusion: Reforming medical insurance system could improve the prescription flow to decrease the hospital pharmacy income, tax on business to increase the hospital pharma⁃ cy operation cost, encourage hospitals to give up pharmacies, so as to achieve the separation of prescription and dispensing. Keywords enterprise boundary theory; separation of prescription and dispensing; prescription flow First-author’saddress China-Japan Friendship Hospital, Beijing, 100029, China CorrespondingauthorWU Feng, E-mail: wofee@ 我国对医药分开的理论探讨已经进行了20 多年， 目前中国基本实现了医药分工，但没有实现医药分 在改革实践中进行了各种尝试。从全国来看，主要有 营，医药合一的经营方式是最大的问题。我们改革的 [1-3] [2] 医药收支两条线，医院药房托管 ，华西模式 ，安徽