我国医药分开政策目的及其策略分析

目的 进一步明确医药分开政策目的及策略。方法 采用文献回顾性研究法，对医药利益链条及其形成原因，以及解决策略进行系统性地总结和分析。结果 现有研究一是认为医疗服务提供方拥有垄断地位造成利益链条存在，因而提出消除垄断；二是认为扭曲的“白色”或不良的“灰色”激励机制造成利益链条存在，因而提出完善“白色”或消除“灰色”激励机制的综合策略。结论 医药利益链条产生更深层次的原因是，非营利性的公立医疗机构不合理地追求经济利益，医生采用不合理方式追求部分合理经济利益。因此，医药分开目的应是让公立医疗机构真正成为非营利机构，使医生依靠技术获得合理的经济回报，让公立医疗机构、医生、政府、患者、药品企业及流通商间激励相容。建议采用外部补偿和内部薪酬制度为重点的综合改革策略，形成各利益相关方激励相容的良好局面，自然消除公立医疗机构、医生与药品销售间利益链条。

Analysis of the Objectives and Strategies of Separating Drug Sales from Medical Services in China

Objective In order to future clarify the purpose and corresponding strategies of separating drug sals from medical services. Method Through using literature study, causes and solutions, interests of chain between the drug sales and medical services were systematic summarized and analyzed. Result Some researchers believed that the monopoly position of the medical service providers caused the existence of the interests of chain, thus they proposed some strategy to breakup monopoly. Others believed that the tortuous formal or under-table incentives mechanism caused the existence of the interests of chain, thus they proposed some strategies to improve the incentives mechanism. Conclusion That public medical institutions unreasonably pursuit economy profits and the physician pursuit reasonable economy profits with the unreasonable way are the deep reason of the chain of drug sales and medical services. Thus, the purpose of the policy is that public medical institutions will become the truly non-profits institutions and the physician will acquire the appropriate compensation according to their technical level. And finally incentive compatibility among all stake holders, such as public medical institutions, doctors, government, patients, and drug companies and so on, should be formed. It is suggested that the comprehensive strategy of improving external and internal compensation system should be used to form the incentive compatibility, thus the interests of the chains will be naturally removed.