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1、 当前我国医疗器械流通领域问题分析及解决对策研究 摘 要 近年来， “看病难、看病贵”逐步成为老百姓反映比较强烈的社会问题。当前，我国政府将解决这一问题提到事关和谐社会建设的战略高度，作为一项重点工作来抓，并从社会各方征求解决的意见与办法。 医疗器械作为一类关系人体健康与生命安全的特殊商品，既是医生籍以医治疾病的有效工具，也是医院主要的收费项目，其流通不仅受到主管部门的严厉监管，也受到社会各界的广泛关注。在当前老百姓“看病难、看病贵”这一社会问题日益突出的背景下，医疗器械流通中存在的诸多问题尤其是流通秩序混乱、监管失控，值得我们深入分析和研究。 本文在系统全面分析我国医疗器械流通现状和该领域存
2、在的问题及其主要影响因素的基础上，充分借鉴欧美发达国家医疗器械流通监管的成功经验，并结合我国的实际情况，从政策制度、市场监管的层面上提出解决这些问题的对策，试图通过这些对策来打破目前的困境，促进我国医疗器械流通的健康发展。 当前,我国医疗器械流通市场的主要特征表现为需求量大， 而经销企业规模普遍偏小，市场集中度低，运营效率低下，流通成本高，中高端产品主要依赖进口，进口大型设备开发利用率低。医疗器械市场价格长期居高不下是我国医疗器械流通领域的突出问题，而需求持续旺盛，通货膨胀导致生产、流通成本上升，税率、汇率推高医疗器械价格，国外厂家技术垄断产生价格垄断，医疗器械流通环节多、过程复杂，信息不对称
3、下的医患委托代理关系，不规范的商业行为等等，便是直接的经济学原因。 影响我国医疗器械流通的因素主要包括技术因素、制度因素和法制因素，其中技术因素和法制因素属系统性因素，技术的改进和法制环境的改善是一个长期的渐进过程，而制度因素作为局部因素，可以通过相关制度的改革来解决医疗器械流通领域中的诸多问题。建立健全公立医院补偿机制，制订医疗器械采购的准入标准，压缩流通环节，促进渠道扁平化、阳光化，建立“医疗第三方”监督机制，建立大型医用设备区域共享体系，适度政府集中生产、集中采购，以保证农村基本医疗器械的有效配置，等等措施，作为解决这些问题的对策将发挥积极有效的作用。 关键词：医疗器械，流通，监管，对策
4、 RESEARCH ON PROBLEMS AND COUNTERMEASURES OF MEDICAL DEVICES CIRCULATING AT PRESENT IN CHINA ABSTRACT People strongly complain recently that it is quite difficult in seeing a doctor and the cost at hospital is much expensive, which gradually becomes a social issue. Presently our government concentra
5、tes much effort to solve this problem when considering this issue relates to construction of a harmonious society, and also makes a survey from societies for different solutions and methods. Medical devices, a special kind of commodity relating to peoples health and life safety, are not only the eff
6、ective tools for doctors to cure illness, but a source of collecting charges for hospital. The circulation of medical devices is strictly supervised by authorities and also concerned by all societies. Under background of issue for difficulty in seeing a doctor, the problem existing in medical device
7、 circulation, especially when poor circulation is out of control and supervision is malfunctioned, requires us to take a further analysis and studies. This paper systematically elaborates current situation, its main problems and root causes for medical device circulation in China. Based on our curre
8、nt system and regulation, as well as marketing supervision on medical devices, the author raises a solution to solve current main problems, after studying some successful experiences on supervision of medical devices in US and Europe and also referring to actual situation in our country. Breaking th
9、rough the present dilemma and developing our medical device circulation along the healthy way is expected under this solution. High demand is a main characters in our medical device circulation marketing. The other characters include small manufacture/sales scale for medical devices, relying on impo
10、rting for middle-end and high-end products and lower utilizing efficiency for imported large-scale medical equipment. Extremely high price of medical devices in long period is a main issue in medical device circulation. Continuous high marketing demands, much high cost for manufacture and circulatio
11、n because of inflation, higher sales price because of tax ratio and currency exchange rate, technical monopoly, complicated circulation, unbalance information for patient and hospital, and even illegal business action are directly the economical reasons. There are three main factors to affect Chinas
12、 medical device circulation. They are including technical factor, regulation factor and law factor. Technical factor and law factor are belonging to systematical factor, improvement on which is gradually forwarding in a much long term, while regulation factor is a factor which can solve many existin
13、g problems in medical device circulation by reforming some related system. The author suggests a solution which can play a great role in solve current existing problem in medical device circulation in China, and the countermeasures include compensation system setup for state-owned hospital, guidelin
14、e for medical device purchasing, minimizing the circulation, channel development, third-party supervision system, public-shared for medical device, effective supplies for medical devices in countryside by governments group manufacturing & purchasing, etc. KEY WORDS: medical devices, circulation, sup
15、ervision, measures 上海交通大学上海交通大学 学位论文原创性声明学位论文原创性声明 本人郑重声明：所呈交的学位论文，是本人在导师的指导下，独立进行研究工作所取得的成果。除文中已经注明引用的内容外，本论文不包含任何其他个人或集体已经发表或撰写过的作品成果。对本文的研究做出重要贡献的个人和集体，均已在文中以明确方式标明。本人完全意识到本声明的法律结果由本人承担。 学位论文作者签名：邹春华 日期：2007 年 12 月 7 日 上海交通大学上海交通大学 学位论文版权使用授权书学位论文版权使用授权书 本学位论文作者完全了解学校有关保留、使用学位论文的规定，同意学校保留并向国家有关部门
16、或机构送交论文的复印件和电子版，允许论文被查阅和借阅。本人授权上海交通大学可以将本学位论文的全部或部分内容编入有关数据库进行检索，可以采用影印、缩印或扫描等复制手段保存和汇编本学位论文。 本学位论文属于： 保密保密 ，在 _ 年解密后适用本授权书。 不保密不保密 。 （请在以上方框内打“”） 学位论文作者签名：邹春华 指导教师签名：黄丞 日期：2007 年 12 月 7 日 日期：2007 年 12 月 7 日 上海交通大学 MBA 学位论文 当前我国医疗器械流通领域问题分析及解决对策研究 1 第 1 章 绪论 1.1 研究背景及意义 刚刚过去的二十世纪是医疗技术迅猛发展的世纪， 全球的医疗卫生事业水平达到了前所未有的高度， 在此期间医疗器械由简易的治疗工具发展成为综合运用各种现代化高新技术的系统性医疗设备， 并成为疾病诊断与治疗不可或缺的工具。 我国的医疗器械行业是在新中国成立后才逐步发展起来的， 由于综合国力薄弱， 加上科学技术落后， 相当长的时期我国该行业始终处于低成本、低技
