浙江省卫生系统商业贿赂案件分析
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摘要
研究目的:了解我省卫生行业商业贿赂现状,分析案件主要特点,表现形式,形成的原因,探讨遏制医药购销领域商业贿赂的方法与对策。
材料与方法:收集了我省卫生系统2001—2005年发生的商业贿赂案件的判决书、不起诉决定书和各级卫生行政部门做出的党政纪处分决定212份。
采用了描述性分析、poisson检验和X~2检验等统计学方法。对我省01-05年间商业贿赂查处案件、案值和人均受贿金额、受贿人职务、职称分布、单位行政级别、文化程度、行贿人性质、行贿领域分布等作了描述性分析;对不同职称、文化程度、单位级别案发率用poisson进行比较,对不同行政级别医院涉案比例使用X~2检验。
结果:
A 2001—2005年我省卫生系统商业贿赂案发数量增长了130.4%,年均增长25.2%,总案值增长351.7%,人均受贿金额增长91.9%,但近年来案发数量增长明显趋缓,2004年和2005年分别仅增长4.1%和3.9%。
B受贿案件多发于医疗机构中高层管理干部和高中级职称卫技人员,其中单位主要领导占40.6%,中层干部占46.2%,高级职称占29.6%,中级职称占40.6%。职称越高受贿金额越大,案发率越高,高级职称人均受贿金额最大为96994.9元,案发率为39.8/万。
C大专学历人员受贿金额最大为87627.6元,学历越高案发率越高,本科与专科学历案发率分别为21.9/万和12.8/万。
D市级医疗卫生机构人员受贿金额最大为88469.3元,但案发率最低仅为3.0/万,县级卫技人员案发率最高为38.5万。省、县两级医院涉案率较高,分别为37.5%和48.7%,乡镇社区医院次之为8.0%,市级医院涉案率最低为5.0%。
E商业贿赂主要集中在药品、医用设备和基建工程等领域,分别为397.0万(占29.0%),343.0万(占27.4%),340.1万(占24.9%),医用耗材领域增长迅速,5年增幅763.9%,单次行贿额基建工程最大为10559.8元、医用设备次之为7997元,药品和耗材最小分别为4578和4953元。
F商业贿赂以单位行贿为主,占总案值的64.6%,但个人行贿增长迅速,5年间增长了616.6%。
讨论与建议:商业贿赂是目前我省卫生系统职务犯罪的主要类型,分析了商业贿赂产生的原因及其发展趋势。受贿人职务、职称、文化程度和所在单位行政级别均不同程度对受贿数额或案发率产生影响,不同行贿领域和行贿主体也存在差异,建议以单位领导干部为重点人群加强对权利运行的监督和制约,以县级医院为主要对象健全监管制度建设、充实纪检力量,以药品、设备、基建为关键领域完善采购制度,改革药品、耗材定价机制,以封堵个人行贿为突破口,尝试实行医药代表登记注册制度,建立医药生产经营企业和销售人员诚信记录,不断完善惩防体系制度建设,加强行业监督管理,遏制医药购销领域商业贿赂。
结论:
A我省卫生系统商业贿赂案件总体增长,增势趋缓。
B具有较高学历、中高级职称的单位领导干部是发生商业贿赂的重点人群。
C县级医院商业贿赂相对高发区。
D商业贿赂主要发生在药品、设备和基建领域,耗材采购方面增长迅速。
E个人行贿增长迅速,有可能成为将来主要的行贿方式。
Objective:The study aim was to assess the commercial bribe situation of health system in Zhejiang province,and explore the main characteristics and possible reason, and then propose the corresponding methods for preventing commercial bribe during ordering medical utilities.
Material and method:We collected 212 commercial bribe cases from decisive amanuensis,non-prosecute document,written judgment and all kinds of punishment document from 2001 to 2005.
The statistical methods of descriptive analysis、poisson test and chi-square test was used in this study.We described the quantity of commercial bribe,total bribery money amount,average bribery amount per person,professional position,title of professional post,department,educational levels of grafters,bribery properity,domain of commercial bribe,and so on.We compared the distribution of commercial bribe between different professional position、educational level and level of department, using poisson test to analysis,respectively.The distribution of commercial bribe was tested between different hospitals by chi-square test
Results:
A From 2001 to 2005,the case quantity of commercial bribe increased 130.4%, and average annual rate reached to 25.2%.Meanwhile,total bribery money amount increased 351.7%and average bribery amount per person increased 91.9%.However, the growth speed of case quantity was slowing down in past two years.The rate of growth was only 4.1%and 3.9%in 2004 and 2005,respectively.
B Most of bribery cases involved in senior administers(main leader:40.6%and middle manager:46.2%) and senior medical practitioners(high professional title: 29.6%and middle:40.6%).The higher the professional position of grafters was,the more amount the bribery money was and the higher bribery risk the individual with higher position had.Average bribery amount per person with high professional title was￥96994.9,and the criminal rate was 39.8/10000 among persons with high professional title.
C The practitioners with junior educational degree took account the most amount of bribes(￥87627.6/person) and frequency of bribery was high correlated with educational level.The criminal rate of the junior and bachelor degree was 12.8/10000 and 21.9/10000,respectively
D The bribery money amount was greatest among city-class practitioners (￥88469.3/person).However,their bribery frequency was lowest(3/10000).The bribery frequency was highest among country-class practitioners(criminal rate: 38.5/10000).The bribery ratio was highest in hospitals of province and country, followed by hospitals of villages,towns and community and lowest in hospitals of city.
E Commercial bribery mainly took place during the dealing of ordering medicine, medical equipments and construction project.The percentage of bribery money amount accounted for 29.0%,27.4%and 24.9%in the dealing of ordering medicine,medical equipments and construction project,respectively.The bribery percentage during dealing of medical expendables was drastically increasing(growth rate:763.9%).The money amount per bribery was maximal during dealing of construction project (￥10559.8/person),followed by the dealing of medical equipments(￥7997/person), and lowest during the dealing of edicine(￥4578/person) and medical expendable(￥4953/person).
F Commercial bribery was mainly conducted by companies(about 64.6%),but individual bribery behavior was increasing rapidly(growth rate:616.6%).
Discuss and advice:Recently,commercial bribe was the main type of crime in health care system in Zhejiang province.Its possible reason and developmental trend were explored in this study.The amount and frequency of bribery were influenced by occupation,title of professional post,educational levels.The bribed objects were changed according to different dealing.To prevent commercial bribe in healthcare system,we suggested the government attempts to strengthen surveillance and management in senior administers,improve the supervising systems in country-class hospitals, establish rules of ordering medicine、medical equipments and construction project,build up register policy for medicine commissary,establish the faith record for medicine corporation and sales man,reform the pricing procedure of medicine and medical expendable,and improve the policy of penalization and prevention system.
Conclusion:
A The quantity of commercial bribe cases was increasing but the growth speed was slowing down.
B Bribery cases were mainly involved in main leaders of medical departments with higher education level and higher title.
C The ratio of bribery was relatively higher in country-class hospitals
D Commercial bribery mainly took place during the dealing of ordering medicine,medical equipments and construction project.The bribery percentageduring dealing of medical expendables was drastically increasing.
E Individual bribery behavior was increasing rapidly.It may become the main form of bribery in the future.
材料与方法:收集了我省卫生系统2001—2005年发生的商业贿赂案件的判决书、不起诉决定书和各级卫生行政部门做出的党政纪处分决定212份。
采用了描述性分析、poisson检验和X~2检验等统计学方法。对我省01-05年间商业贿赂查处案件、案值和人均受贿金额、受贿人职务、职称分布、单位行政级别、文化程度、行贿人性质、行贿领域分布等作了描述性分析;对不同职称、文化程度、单位级别案发率用poisson进行比较,对不同行政级别医院涉案比例使用X~2检验。
结果:
A 2001—2005年我省卫生系统商业贿赂案发数量增长了130.4%,年均增长25.2%,总案值增长351.7%,人均受贿金额增长91.9%,但近年来案发数量增长明显趋缓,2004年和2005年分别仅增长4.1%和3.9%。
B受贿案件多发于医疗机构中高层管理干部和高中级职称卫技人员,其中单位主要领导占40.6%,中层干部占46.2%,高级职称占29.6%,中级职称占40.6%。职称越高受贿金额越大,案发率越高,高级职称人均受贿金额最大为96994.9元,案发率为39.8/万。
C大专学历人员受贿金额最大为87627.6元,学历越高案发率越高,本科与专科学历案发率分别为21.9/万和12.8/万。
D市级医疗卫生机构人员受贿金额最大为88469.3元,但案发率最低仅为3.0/万,县级卫技人员案发率最高为38.5万。省、县两级医院涉案率较高,分别为37.5%和48.7%,乡镇社区医院次之为8.0%,市级医院涉案率最低为5.0%。
E商业贿赂主要集中在药品、医用设备和基建工程等领域,分别为397.0万(占29.0%),343.0万(占27.4%),340.1万(占24.9%),医用耗材领域增长迅速,5年增幅763.9%,单次行贿额基建工程最大为10559.8元、医用设备次之为7997元,药品和耗材最小分别为4578和4953元。
F商业贿赂以单位行贿为主,占总案值的64.6%,但个人行贿增长迅速,5年间增长了616.6%。
讨论与建议:商业贿赂是目前我省卫生系统职务犯罪的主要类型,分析了商业贿赂产生的原因及其发展趋势。受贿人职务、职称、文化程度和所在单位行政级别均不同程度对受贿数额或案发率产生影响,不同行贿领域和行贿主体也存在差异,建议以单位领导干部为重点人群加强对权利运行的监督和制约,以县级医院为主要对象健全监管制度建设、充实纪检力量,以药品、设备、基建为关键领域完善采购制度,改革药品、耗材定价机制,以封堵个人行贿为突破口,尝试实行医药代表登记注册制度,建立医药生产经营企业和销售人员诚信记录,不断完善惩防体系制度建设,加强行业监督管理,遏制医药购销领域商业贿赂。
结论:
A我省卫生系统商业贿赂案件总体增长,增势趋缓。
B具有较高学历、中高级职称的单位领导干部是发生商业贿赂的重点人群。
C县级医院商业贿赂相对高发区。
D商业贿赂主要发生在药品、设备和基建领域,耗材采购方面增长迅速。
E个人行贿增长迅速,有可能成为将来主要的行贿方式。
Objective:The study aim was to assess the commercial bribe situation of health system in Zhejiang province,and explore the main characteristics and possible reason, and then propose the corresponding methods for preventing commercial bribe during ordering medical utilities.
Material and method:We collected 212 commercial bribe cases from decisive amanuensis,non-prosecute document,written judgment and all kinds of punishment document from 2001 to 2005.
The statistical methods of descriptive analysis、poisson test and chi-square test was used in this study.We described the quantity of commercial bribe,total bribery money amount,average bribery amount per person,professional position,title of professional post,department,educational levels of grafters,bribery properity,domain of commercial bribe,and so on.We compared the distribution of commercial bribe between different professional position、educational level and level of department, using poisson test to analysis,respectively.The distribution of commercial bribe was tested between different hospitals by chi-square test
Results:
A From 2001 to 2005,the case quantity of commercial bribe increased 130.4%, and average annual rate reached to 25.2%.Meanwhile,total bribery money amount increased 351.7%and average bribery amount per person increased 91.9%.However, the growth speed of case quantity was slowing down in past two years.The rate of growth was only 4.1%and 3.9%in 2004 and 2005,respectively.
B Most of bribery cases involved in senior administers(main leader:40.6%and middle manager:46.2%) and senior medical practitioners(high professional title: 29.6%and middle:40.6%).The higher the professional position of grafters was,the more amount the bribery money was and the higher bribery risk the individual with higher position had.Average bribery amount per person with high professional title was￥96994.9,and the criminal rate was 39.8/10000 among persons with high professional title.
C The practitioners with junior educational degree took account the most amount of bribes(￥87627.6/person) and frequency of bribery was high correlated with educational level.The criminal rate of the junior and bachelor degree was 12.8/10000 and 21.9/10000,respectively
D The bribery money amount was greatest among city-class practitioners (￥88469.3/person).However,their bribery frequency was lowest(3/10000).The bribery frequency was highest among country-class practitioners(criminal rate: 38.5/10000).The bribery ratio was highest in hospitals of province and country, followed by hospitals of villages,towns and community and lowest in hospitals of city.
E Commercial bribery mainly took place during the dealing of ordering medicine, medical equipments and construction project.The percentage of bribery money amount accounted for 29.0%,27.4%and 24.9%in the dealing of ordering medicine,medical equipments and construction project,respectively.The bribery percentage during dealing of medical expendables was drastically increasing(growth rate:763.9%).The money amount per bribery was maximal during dealing of construction project (￥10559.8/person),followed by the dealing of medical equipments(￥7997/person), and lowest during the dealing of edicine(￥4578/person) and medical expendable(￥4953/person).
F Commercial bribery was mainly conducted by companies(about 64.6%),but individual bribery behavior was increasing rapidly(growth rate:616.6%).
Discuss and advice:Recently,commercial bribe was the main type of crime in health care system in Zhejiang province.Its possible reason and developmental trend were explored in this study.The amount and frequency of bribery were influenced by occupation,title of professional post,educational levels.The bribed objects were changed according to different dealing.To prevent commercial bribe in healthcare system,we suggested the government attempts to strengthen surveillance and management in senior administers,improve the supervising systems in country-class hospitals, establish rules of ordering medicine、medical equipments and construction project,build up register policy for medicine commissary,establish the faith record for medicine corporation and sales man,reform the pricing procedure of medicine and medical expendable,and improve the policy of penalization and prevention system.
Conclusion:
A The quantity of commercial bribe cases was increasing but the growth speed was slowing down.
B Bribery cases were mainly involved in main leaders of medical departments with higher education level and higher title.
C The ratio of bribery was relatively higher in country-class hospitals
D Commercial bribery mainly took place during the dealing of ordering medicine,medical equipments and construction project.The bribery percentageduring dealing of medical expendables was drastically increasing.
E Individual bribery behavior was increasing rapidly.It may become the main form of bribery in the future.
引文
[1]黄赤东,孔祥俊主编.反不正当竞争法及配套规定新释新解、北京:人民法院出版社,2001:284-289
[2]付立忠.刑法修正案(六)对商业贿赂犯罪之改进问题研究.中国人民公安大学学报(社会科学版).2006,4,21-23.
[3]蔡桂生.探析商业贿赂之回扣行为的刑法控制.http://article.chinalawinfo.com/article/user/article_display.asp?ArticleID=38764
[4]杨成志.中国医界掀起反商业贿赂风暴.当代医学.2006,2:20-22.
[5]许国强.对医药行业贪污贿赂犯罪案件的分析与对策.中国医院管理[J].2004,10:28-29.
[6]李如清,代震军,王旭.抓准突破口查处医药购销中的商业贿赂行为.工商行政管理[J].2005,1O:23-24
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[12]徐翔,王黎霞.医药分业存在的问题与对策.中华医院管理杂志.2005,1:60
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[1]许国强.对医药行业贪污贿赂犯罪案件的分析与对策.中国医院管理[J].2004,10:28-29.
[2]付立忠.刑法修正案(六)对商业贿赂犯罪之改进问题研究.中国人民公安大学学报(社会科学版).2006,4,21-23.
[3]黄赤东,孔祥俊主编.反不正当竞争法及配套规定新释新解、北京:人民法院出版社,2001:284-289
[4]杨成志.中国医界掀起反商业贿赂风暴.当代医学.2006,2:20-22.
[5]匿名.浙江3年查商业贿赂案2132件查处13名厅级干部.http://news.china.com/zh_cn/domestic/945/20060519/13330604.html/2006-05-19
[6]汪发元,汪玲俐.论医药公司商业贿赂和质量保证金.工商行政管理.2005,1O:12-13.
[7]姚丽芬,严晋,魏榕清.建立以预防为主体的监督体系防治医药购销领域商业贿赂冲医药管理杂志.2007;15(7):479-481
[8]李如清,代震军,王旭.抓准突破口查处医药购销中的商业贿赂行为.工商行政管理[J].2005,1O:23-24
[9]武镇,王文斌,陈辉.遏制医疗卫生系统犯罪.发展研究.2006,3:101-102
[10]徐翔,王黎霞.医药分业存在的问题与对策.中华医院管理杂志.2005,1:60
[11]朱有明,张薛梅.我国商业贿赂现状的经济学分析.商场现代化.2006,3:6-7
[12]李小玲.关于治理医药购销领域商业贿赂的几点思考.中医药管理杂志。2008;16(3):175-176
[13]汤水明,徐周佳.药品购销环节商业贿赂治理方法之探析.卫生经济研究。2008;4:41-42
[14]于德志,石光,王明砚,田晓晓.取消“以药补医”切断医药经济利益联系建立防控医药购销领域商业贿赂的长效机制.中国卫生经济。2008;27(2):14-16
[15]蔡桂生.探析商业贿赂之回扣行为的刑法控制.http://article.chinalawinfo.com/article/user/article_display.asp?ArticleID=38764
[16]匿名.当前打击预防医药购销领域商业贿赂犯罪的对策.http://www.lunwentianxia.com/product.free.9451920.3/
[17]QU Xue-wu.Legal Thinking on Advancing System of Rule by Law Combating Business Bribery in China.Hebei Law Science.2006.6:25
[18]Wan Guohua.Ways to Anti-Commercial-Bribery from View of Legal Institution of Corporate Governance.Nankai Journal(Philosophy,Literature and Social Science Edition).2008.2:8-9
[19]高强.卫生事业的改革与发展.http://news.Xinhuanet.com/health/2005-08-01
[20]Tian Kai.The Components of Commercial Bribery Crime in Medical Industry and Its Prevention.Criminal Research.2006.6:36-37
[21]Chen Xiaoxchun,Zhang Juan.Anti-commercial-bribery and the Perfection of Government Procurement Mechanism.The Theory and Practice of Finance and Economics.2006.5:33-35
[22]宰章忠.以科学发展观引领医药购销领域商业贿赂治理工作.中国卫生事业管理.2007;2:112-113.
[2]付立忠.刑法修正案(六)对商业贿赂犯罪之改进问题研究.中国人民公安大学学报(社会科学版).2006,4,21-23.
[3]蔡桂生.探析商业贿赂之回扣行为的刑法控制.http://article.chinalawinfo.com/article/user/article_display.asp?ArticleID=38764
[4]杨成志.中国医界掀起反商业贿赂风暴.当代医学.2006,2:20-22.
[5]许国强.对医药行业贪污贿赂犯罪案件的分析与对策.中国医院管理[J].2004,10:28-29.
[6]李如清,代震军,王旭.抓准突破口查处医药购销中的商业贿赂行为.工商行政管理[J].2005,1O:23-24
[7]武镇,王文斌,陈辉.遏制医疗卫生系统犯罪.发展研究.2006,3:101-102
[8]xinhua.Commercial Bribery—Foreign Companies Adapt to Local Market in Wrong Way.http://english.cri.cn/3126/2006/11/24/264@167029.htm
[9]Wan Guohua.Ways to Anti-Commercial-Bribery from View of Legal Institution of Corporate Governance.Nankai Journal(Philosophy,Literature and Social Science Edition).2008.2:8-9
[10]朱有明,张薛梅.我国商业贿赂现状的经济学分析.商场现代化.2006,3:6-7
[11]汪发元,汪玲俐.论医药公司商业贿赂和质量保证金.工商行政管理.2005,1O:12-13.
[12]徐翔,王黎霞.医药分业存在的问题与对策.中华医院管理杂志.2005,1:60
[13]高强.卫生事业的改革与发展.http://news.Xinhuanet.com/health/2005-08-01
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[16]匿名.浙江3年查商业贿赂案2132件查处13名厅级干部.http://news.china.com/zh_cn/domestic/945/20060519/13330604.html/2006-05-19
[17]匿名.全国查处医药领域商业贿赂案790件1160人涉案.htlp://news.xinhuanet.com/legal/2006-10/17/content_5211951.htm
[18]姚丽芬,严晋,魏榕清.建立以预防为主体的监督体系防治医药购销领域商业贿赂.中医药管理杂志.2007;15(7):479-481
[19]QU Xue-wu.Legal Thinking on Advancing System of Rule by Law Combating Business Bribery in China.Hebei Law Science.2006.6:25
[20]Tian Kai.The Components of Commercial Bribery Crime in Medical Industry and Its Prevention.Criminal Research.2006.6:36-37
[21]汤水明,徐周佳.药品购销环节商业贿赂治理方法之探析.卫生经济研究。2008;4:41-42
[22]Chen Xiaoxchun,Zhang Juan.Anti-commercial-bribery and the Perfection of Government Procurement Mechanism.The Theory and Practice of Finance and Economics.2006.5:33 -35
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[24]宰章忠.以科学发展观引领医药购销领域商业贿赂治理工作.中国卫生事业管理.2007;2:112-113.
[25]于德志,石光,王明砚,田晓晓.取消“以药补医”切断医药经济利益联系建立防控医药购销领域商业贿赂的长效机制.中国卫生经济。2008;27(2):14-16
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[1]许国强.对医药行业贪污贿赂犯罪案件的分析与对策.中国医院管理[J].2004,10:28-29.
[2]付立忠.刑法修正案(六)对商业贿赂犯罪之改进问题研究.中国人民公安大学学报(社会科学版).2006,4,21-23.
[3]黄赤东,孔祥俊主编.反不正当竞争法及配套规定新释新解、北京:人民法院出版社,2001:284-289
[4]杨成志.中国医界掀起反商业贿赂风暴.当代医学.2006,2:20-22.
[5]匿名.浙江3年查商业贿赂案2132件查处13名厅级干部.http://news.china.com/zh_cn/domestic/945/20060519/13330604.html/2006-05-19
[6]汪发元,汪玲俐.论医药公司商业贿赂和质量保证金.工商行政管理.2005,1O:12-13.
[7]姚丽芬,严晋,魏榕清.建立以预防为主体的监督体系防治医药购销领域商业贿赂冲医药管理杂志.2007;15(7):479-481
[8]李如清,代震军,王旭.抓准突破口查处医药购销中的商业贿赂行为.工商行政管理[J].2005,1O:23-24
[9]武镇,王文斌,陈辉.遏制医疗卫生系统犯罪.发展研究.2006,3:101-102
[10]徐翔,王黎霞.医药分业存在的问题与对策.中华医院管理杂志.2005,1:60
[11]朱有明,张薛梅.我国商业贿赂现状的经济学分析.商场现代化.2006,3:6-7
[12]李小玲.关于治理医药购销领域商业贿赂的几点思考.中医药管理杂志。2008;16(3):175-176
[13]汤水明,徐周佳.药品购销环节商业贿赂治理方法之探析.卫生经济研究。2008;4:41-42
[14]于德志,石光,王明砚,田晓晓.取消“以药补医”切断医药经济利益联系建立防控医药购销领域商业贿赂的长效机制.中国卫生经济。2008;27(2):14-16
[15]蔡桂生.探析商业贿赂之回扣行为的刑法控制.http://article.chinalawinfo.com/article/user/article_display.asp?ArticleID=38764
[16]匿名.当前打击预防医药购销领域商业贿赂犯罪的对策.http://www.lunwentianxia.com/product.free.9451920.3/
[17]QU Xue-wu.Legal Thinking on Advancing System of Rule by Law Combating Business Bribery in China.Hebei Law Science.2006.6:25
[18]Wan Guohua.Ways to Anti-Commercial-Bribery from View of Legal Institution of Corporate Governance.Nankai Journal(Philosophy,Literature and Social Science Edition).2008.2:8-9
[19]高强.卫生事业的改革与发展.http://news.Xinhuanet.com/health/2005-08-01
[20]Tian Kai.The Components of Commercial Bribery Crime in Medical Industry and Its Prevention.Criminal Research.2006.6:36-37
[21]Chen Xiaoxchun,Zhang Juan.Anti-commercial-bribery and the Perfection of Government Procurement Mechanism.The Theory and Practice of Finance and Economics.2006.5:33-35
[22]宰章忠.以科学发展观引领医药购销领域商业贿赂治理工作.中国卫生事业管理.2007;2:112-113.