[1]丁瑞琳,颜建周,李馨雨,等.定点零售药店纳入门诊统筹管理政策的实施难点分析[J].卫生经济研究,2025,42(09):14-18.
　DING Ruilin,YAN Jianzhou,LI Xinyu,et al.Analysis of the Implementation Difficulties of the Policies for Incorporating Designated Retail Pharmacies into Outpatient Pooling Fund Management[J].Journal Press of Health Economics Research,2025,42(09):14-18.
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定点零售药店纳入门诊统筹管理政策的实施难点分析

卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
42
期数:
2025年09期
页码:
14-18
栏目:
政策视野
出版日期:
2025-08-28

文章信息/Info

Title:
Analysis of the Implementation Difficulties of the Policies for Incorporating Designated Retail Pharmacies into Outpatient Pooling Fund Management
作者:
丁瑞琳1; 颜建周1; 李馨雨1; 欧阳沁1; 邵 蓉1
1.中国药科大学国家药物政策与医药产业经济研究中心，江苏 南京 211198
Author(s):
DING Ruilin;  YAN Jianzhou;  LI Xinyu;  OUYANG Qin;  SHAO Rong
Research Center for National Drug Policy & Ecosystem, China Pharmaceutical University, Nanjing Jiangsu 211198, China
关键词:
零售药店; 门诊统筹; 药品集中采购; 医保支付标准
Keywords:
retail pharmacies;  outpatient pooling fund management;  drug centralized procurement;  medical insurance payment standards
分类号:
F840；R95
文献标志码:
A
摘要:
目的：分析定点零售药店纳入门诊统筹管理政策的实施难点，提出优化建议。方法：通过实地调研，分析政策实施难点；采用政策文本分析，总结典型地区的实践做法。结果：定点零售药店纳入门诊统筹管理政策主要存在处方获得与流转困难、非处方药品需处方才能统筹支付、医药机构药品匹配度不高、零售药店药品价格和医保支付管理难度大、医保个人账户和统筹账户存在制度矛盾等难点；一些典型地区根据实际情况进行了实践探索，对政策完善具有借鉴意义。结论：差异化设置不同情形的门诊统筹处方要求，兼顾基金安全与购药便利度；打破医、药、患之间的信息壁垒，构建公正透明的药品零售市场；利用集采规范零售药品采购，建立科学的医保支付标准形成机制；完善医保制度设计，调和“个账统账”矛盾。
Abstract:
Objective To analyze the implementation difficulties of the policies for incorporating designated retail pharmacies into outpatient pooling fund management. Methods The field research was used to analyze the implementation difficulties of the policy, and the policy text analysis was used to summarize best practices from typical regions. Results The implementation of the policies for incorporating designated retail pharmacies into outpatient pooling fund management mainly faced difficulties such as the difficulties in the acquisition and circulation of prescriptions, and so on. Some typical regions had good practice explorations based on local conditions, which had valuable reference for policy improvement. Conclusion It is recommended to set differentiated prescription requirements for outpatient pooling fund management in different situations, break down information barriers between medical institutions and patients, standardize retail drug procurement and establish a scientific payment standard formation mechanism, and improve the design of the medical insurance system to resolve the conflicts between medical insurance personal and the pooling fund.

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更新日期/Last Update: 2025-08-28