关于我国药学服务控制药品费用机制的思考
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摘要
根据药学服务国际标准定义和实施目标,结合我国最新药学服务相关法律法规,分析我国药学服务控制药品费用的内在机制和实际实施障碍。药学服务虽然能够在一定程度上控制药品费用,但相对不高的药学服务人员水平、有待提高的药学服务管理机制以及有待完善相关政策制约了药学服务对药品费用的控制。建议提升药学服务人员水平、优化管理机制、加快相关政策的制定能最大限度地发挥药学服务的控费功能。
Analyzing the mechanism and implementation barriers of drug cost management by pharmaceutical care referring toglobal standardized definition and implementation goals of pharmaceutical care combined with latest published laws and regulations inChina. Though the pharmaceutical care could control drug cost to a certain extent, but relatively insufficient professional capability ofproviders, the deficient management mechanisms and imperfect relevant policies and systems were barriers of pharmaceutical caredrug cost management. It suggested to improve the service capability of pharmaceutical care providers, optimize the management mech-anism, and accelerate the formulation of related policies and systems, which could be applicable paths of optimizing drug cost manage-ment mechanism of pharmaceutical care.
Analyzing the mechanism and implementation barriers of drug cost management by pharmaceutical care referring toglobal standardized definition and implementation goals of pharmaceutical care combined with latest published laws and regulations inChina. Though the pharmaceutical care could control drug cost to a certain extent, but relatively insufficient professional capability ofproviders, the deficient management mechanisms and imperfect relevant policies and systems were barriers of pharmaceutical caredrug cost management. It suggested to improve the service capability of pharmaceutical care providers, optimize the management mech-anism, and accelerate the formulation of related policies and systems, which could be applicable paths of optimizing drug cost manage-ment mechanism of pharmaceutical care.
引文
[1]王建平,姜丽丽,陆建立.积极开展药学服务有效遏制药品费用的不合理增长[J].中国药物与临床,2005(5):397-398.
[2]寇宗来.“以药养医”与“看病贵、看病难”[J].世界经济,2010,33(1):49-68.
[3]邹蔼珍,吴雪峰,庞惠民,等.门诊不合理大处方成因分析[J].中国医药科学,2013(1):142-144.
[4]HEPLER C D,STRAND L M.Opportunities and responsibili-ties in pharmaceutical care[J].American journal of hospitalpharmacy,1990,47(3):533-543.
[5]ASHP guidelines on a standardized method for pharmaceutical care.American Society of Health-System Pharmacists[J].American journal of health-system pharmacy,1996,53(14):1713-1716.
[6]World Health Organization.The Pursuit of Responsible Useof Medicines:Sharing and Learning from Country Experiences[EB/OL].(2012-3)[2017-09-10].http://www.who.int/medi-cines/areas/rational_use/en/.
[7]ASHP.ASHP guidelines on medication cost managementstrategies for hospitals and health systems[J].American jour-nal of health-system pharmacy,2008,65(14):1368-1384.
[8]李洁,陈伟成,张立超,等.通过门诊处方审核与点评分析提高合理用药水平[J].药学服务与研究,2015,15(01):18-21.
[9]张凤莲,于腾飞.“四查十对”对于药剂师的重要性[J].中国实用医药,2009,35(4):264-265.
[10]郑家龙,段国峰.临床药师药学查房工作模式的初探[J].抗感染药学,2012,9(1):67-69.
[11]余爱荣,范星,周帆,等.临床药师参与抗感染治疗的药学监护切入点[J].中国药师,2014,17(10):1724-1728.
[12]胡燕,白继庚,胡先明,等.我国抗生素滥用现状、原因及对策探讨[J].中国社会医学杂志,2013,30(2):128-130.
[13]金丹,董铎,魏晶,等.中国药品不良反应成因分析及预防措施[J].中国新药杂志,2009,18(24):2376-2381.
[14]梁延平,王蕊,刁瑞刚.药学咨询服务分析及发展策略[J].中国医院药学杂志,2006(12):1557-1559.
[15]胡晋红,蔡溱,孙华君.药学服务与全程化药学服务[J].药学服务与研究,2008(3):161-165.
[16]魏际刚.中国医药体制改革与发展[M].上海:商务印书馆,2009.
[17]赵志刚.中国药学服务标准与收费研究蓝皮书(2016版)[M].北京:人民卫生出版社,2016.
[18]周福成.切实有效提升能力水平全面强化执业药师素质[J].中国执业药师,2014,11(9):37-39.
[19]邢冶.规范药房管理对于完善药学服务水平的意义分析[J].中国医药指南,2014,12(11):390-391.
[20]王晓璐,魏水易,纪晖.建立合理的临床药师职称制度、激励机制以及教育制度[J].中国临床药学杂志,2004(3):190-192.
[21]问媛媛,杨世民,方宇.高等药学教育与执业药师(临床药师)功能衔接的研究[J].药学教育,2010,26(3):57-59.
[22]韩庆礼.医院药房管理中存在的问题及其改进措施[J].当代医学,2011,17(10):34+37.
[23]谢慧媛,雷霞芬,李剑婷,等.药师的药学服务在药事服务费中的价值体现探讨[J].中国药房,2011,22(17):1550-1552.
[24]梁海珊,张新平.我国药学服务开展过程中存在的问题与对策[J].医学与社会,2010,23(5):43-45.
[25]金剑,舒丽芯.医疗机构完善药学服务的宏观政策需求[J].中国药房,2004(10):7-9.
[2]寇宗来.“以药养医”与“看病贵、看病难”[J].世界经济,2010,33(1):49-68.
[3]邹蔼珍,吴雪峰,庞惠民,等.门诊不合理大处方成因分析[J].中国医药科学,2013(1):142-144.
[4]HEPLER C D,STRAND L M.Opportunities and responsibili-ties in pharmaceutical care[J].American journal of hospitalpharmacy,1990,47(3):533-543.
[5]ASHP guidelines on a standardized method for pharmaceutical care.American Society of Health-System Pharmacists[J].American journal of health-system pharmacy,1996,53(14):1713-1716.
[6]World Health Organization.The Pursuit of Responsible Useof Medicines:Sharing and Learning from Country Experiences[EB/OL].(2012-3)[2017-09-10].http://www.who.int/medi-cines/areas/rational_use/en/.
[7]ASHP.ASHP guidelines on medication cost managementstrategies for hospitals and health systems[J].American jour-nal of health-system pharmacy,2008,65(14):1368-1384.
[8]李洁,陈伟成,张立超,等.通过门诊处方审核与点评分析提高合理用药水平[J].药学服务与研究,2015,15(01):18-21.
[9]张凤莲,于腾飞.“四查十对”对于药剂师的重要性[J].中国实用医药,2009,35(4):264-265.
[10]郑家龙,段国峰.临床药师药学查房工作模式的初探[J].抗感染药学,2012,9(1):67-69.
[11]余爱荣,范星,周帆,等.临床药师参与抗感染治疗的药学监护切入点[J].中国药师,2014,17(10):1724-1728.
[12]胡燕,白继庚,胡先明,等.我国抗生素滥用现状、原因及对策探讨[J].中国社会医学杂志,2013,30(2):128-130.
[13]金丹,董铎,魏晶,等.中国药品不良反应成因分析及预防措施[J].中国新药杂志,2009,18(24):2376-2381.
[14]梁延平,王蕊,刁瑞刚.药学咨询服务分析及发展策略[J].中国医院药学杂志,2006(12):1557-1559.
[15]胡晋红,蔡溱,孙华君.药学服务与全程化药学服务[J].药学服务与研究,2008(3):161-165.
[16]魏际刚.中国医药体制改革与发展[M].上海:商务印书馆,2009.
[17]赵志刚.中国药学服务标准与收费研究蓝皮书(2016版)[M].北京:人民卫生出版社,2016.
[18]周福成.切实有效提升能力水平全面强化执业药师素质[J].中国执业药师,2014,11(9):37-39.
[19]邢冶.规范药房管理对于完善药学服务水平的意义分析[J].中国医药指南,2014,12(11):390-391.
[20]王晓璐,魏水易,纪晖.建立合理的临床药师职称制度、激励机制以及教育制度[J].中国临床药学杂志,2004(3):190-192.
[21]问媛媛,杨世民,方宇.高等药学教育与执业药师(临床药师)功能衔接的研究[J].药学教育,2010,26(3):57-59.
[22]韩庆礼.医院药房管理中存在的问题及其改进措施[J].当代医学,2011,17(10):34+37.
[23]谢慧媛,雷霞芬,李剑婷,等.药师的药学服务在药事服务费中的价值体现探讨[J].中国药房,2011,22(17):1550-1552.
[24]梁海珊,张新平.我国药学服务开展过程中存在的问题与对策[J].医学与社会,2010,23(5):43-45.
[25]金剑,舒丽芯.医疗机构完善药学服务的宏观政策需求[J].中国药房,2004(10):7-9.