摘 要
当前我国医改越发艰难，医患矛盾开始变得日益突出。长期以来“以药补医”是公立医院维持运行和发展的主要政策，阻碍现行医疗体制健康、有序发展，违背了公平、公正、透明、公开的原则。针对上述现象，国家退出了一系列医疗体制改革，并出台了《中共中央国务院关于深化医药卫生体制改革的意见》。尝试通过实行药品零差价政策，同时增加药事服务费，提高医疗服务的价格，适当增加政府财政补贴，改变医保支付方式的方法增加公立医院的补偿。尝试解决能解决老百姓看病困难，看病价格虚高，因病导致贫困的现实。使老百姓得到实惠，医院健康发展，政府实惠于民。在此背景下，对公立医院的药品零售进行改革创新，并努力实现其背景原因和因素，提出更好的解决方法和思路。
文章通过国家省市公立医院的改革试点，河北唐山市公立医院为研究目标，并针对当地的研究政策和内容给予药品零差率进行改革，并根据情况实施深入研究，以此为基础，对其他地区的药品进行改革实时操作，并针对零差率的药品进行一定的参考，本文主要划分为五个部分进行讲述：
首先，第一部分主要讲述了概论，并针对具体的概念给予相应的解释，并针对论文的研究背景，提供相应的研究现状以及意义。
第二部分主要讲述了研究方法和流程，针对本文中的相关资料，对研究的方法和技巧进行解释。
第三部分针对河北省唐山市某人民医院的具体情况，以及实施药品零差率的整个过程，并对唐山市人民医院的药品改革采取相关措施，以便实现零差率。
第四部分在上述分析的过程中，以唐山市某人民医院中药品零差率实施的主要过程以及政策上所出现的失误和缺陷进行改善，例如，如果药品的回扣无法进行有效治理，将使得患者无法享受到药品零差率后所带来的优惠政策，而且药品价格依然只高不下，最后针对个别现象进行相关原因的解析。
第五，从不同角度进行出发，并针对不同种类的药品价格问题，解决药品回扣和虚高等问题，全面解决药品价格不对等的关系，有效保障医院的公益性和支付政策， 以较好的巩固药品实施的整个流程，使得药品市场秩序能够得到有效保证。
关键词：医改；公立医院；药品零差率；政策
ABSTRACT
In today's society, conflicts between doctors and patients are more prominent, "medicine" is mainly used to survive in public hospitals policy and being seen as the largest of the modern medical industry "cancer" one. Face this class phenomenon, related national take has new a round of medicine system reform, and introduced related management policy CPC Central Committee State on deepening medicine health reform of views, according to by through of drug purchase and sale price and drug service fee, many system of reform and added into policy, on medical service price take appropriate of adjustment, and increased Government of overall input, makes in must degree Shang perfect on public hospital of medical added degree, and can real solution people "doctor difficult and doctor your", problem, Medical care affordable and comprehensive solution to the people issues, allowing hospitals to better, more caring of the Government to the people. In this context, reform of public hospital pharmaceutical retail innovation, and strive to achieve their backgrounds and factors, and come up with better solutions and ideas.
Articles through national provinces public hospital of reform pilot, Hebei Tangshan City public hospital for research target, and for local of research policy and content give drug 0 poor rate for reform, and according to situation implementation in-depth research, to this for based, on other area of drug for reform real-time operation, and for 0 poor rate of drug for must of reference, paper main divided for five a part for tells:
First of all, the first part focuses on the introduction to and concepts appropriate for specific types of explanation and background papers, provide the status and significance of the research.
Part II focuses on the methods and processes for the relevant information in this article, to explain the research methods and techniques.
The third part, the specific circumstances of Tangshan City, Hebei province luanxian County people's Hospital, as well as medicines throughout the process of zero-profit, and the Tangshan people's hospital drug reform measures in order to achieve a zero rate.
IV, in above analysis of process in the, to, Tangshan City, Luan people hospital in the drug 0 poor rate implementation of main process and policy Shang by appeared of errors and defects for improved, for example, if drug of rebate cannot for effective governance, will makes patients cannot enjoy to drug 0 poor rate Hou by brings of offers policy, and drug price still only high down, last for individual phenomenon for related reasons of analytical.
Finally, starting from different angles, and different kinds of drug prices, drug rebate and imaginary problems, comprehensive solution to the drug price unequal relationship, effective protection of hospital of public and policy in order to better consolidate the implementation of the drug throughout the process, the drug market order can be guaranteed.
Keywords：Health care reform；Public hospitals；Drugs zero rate；Policy
目 录
摘 要 1
1.1 研究背景 6
1.2 研究目的意义 7
1.3 国内外研究现状 8
第二章 研究过程和方法 10
2.1 资料来源 10
2.2 研究方法 10
2.2.1 参考相关文献 10
2.
