我国各地区药品使用监控政策的分析与思考
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摘要
目的整理与分析我国各省市现阶段有关药品使用监控的政策内容,为进一步控制医疗机构药品费用的增长提供实践参考依据。方法对各省市卫生计生(卫生健康)委网站进行查询,收录各地有关药品使用监控的政策文件及药品使用监控目录,对政策主要内容、目录遴选标准和目录品种3方面进行关键词提取及频数统计,从而分析各地药品使用监控政策的特点。结果 (1)我国共有22个省区市出台了市级以上的药品使用监控相关政策文件,重点药品使用的监控工作在各地的落实较好,药品使用监控的政策已覆盖大部分地区。(2)各地对药品使用监控目录的遴选标准较为一致,被提及最多的是需细化被监控的药品种类,且各地均十分关注辅助类用药、中成药、营养类药物的临床使用。(3)从各地药品使用监控目录中共整理出39类辅助类药品、81类中成药、16类营养类药品、7类质子泵抑制剂类药品、31类抗生素类药品、21类维生素类药品、81类其他治疗类药品。结论我国药品使用监控应:(1)"先行者"带动"后行者",全面落实药品使用监控政策;(2)引入科学评价体系,统一建立药品使用监控目录遴选标准;(3)统一药品使用监控细度,重点关注医疗机构临床合理用药问题。
Objective To analyze the regional policy of drug usage monitoring in China,in order to make theoretical and practical contribution to the further control of the growth of drug costs in medical institutions. Methods Through querying the Health and Family Planning Commission Website in various provinces and cities,collecting drug usage monitoring policy documents and directories,then extracting the key words from these documents and lists,as well as calculating the frequency of the key words,which may help to summarize the characteristics of regional drug usage monitoring policy and list. Results(1)There are civic drug usage monitoring policy documents in 22 provinces in China,which means the drug usage monitoring work is well done in China.(2)The selection standard of drug use monitoring list is almost the same,and the most mentioned standard among them is refining the drug category. At the same time,adjuvant drugs,Chinese medicine and nutritive medicine have got a lot of attention.(3)39 kinds of adjuvant drugs,81 kinds of Chinese medicine,16 kinds of nutritive medicine,7 kinds of proton-pump inhibitors,31 kinds of antibiotic,21 kinds of vitamin and 81 kinds of other drugs are sorted out. Conclusion Suggestions are as follows,(1)The pioneers should guide other locations to establish a comprehensive drug use monitoring policy.(2)A scientific evaluation system should be used to establish unified selection criteria.(3)The drug use monitoring size should be unified,and the rational use of drugs in clinical practice in medical institutions be focused on.
Objective To analyze the regional policy of drug usage monitoring in China,in order to make theoretical and practical contribution to the further control of the growth of drug costs in medical institutions. Methods Through querying the Health and Family Planning Commission Website in various provinces and cities,collecting drug usage monitoring policy documents and directories,then extracting the key words from these documents and lists,as well as calculating the frequency of the key words,which may help to summarize the characteristics of regional drug usage monitoring policy and list. Results(1)There are civic drug usage monitoring policy documents in 22 provinces in China,which means the drug usage monitoring work is well done in China.(2)The selection standard of drug use monitoring list is almost the same,and the most mentioned standard among them is refining the drug category. At the same time,adjuvant drugs,Chinese medicine and nutritive medicine have got a lot of attention.(3)39 kinds of adjuvant drugs,81 kinds of Chinese medicine,16 kinds of nutritive medicine,7 kinds of proton-pump inhibitors,31 kinds of antibiotic,21 kinds of vitamin and 81 kinds of other drugs are sorted out. Conclusion Suggestions are as follows,(1)The pioneers should guide other locations to establish a comprehensive drug use monitoring policy.(2)A scientific evaluation system should be used to establish unified selection criteria.(3)The drug use monitoring size should be unified,and the rational use of drugs in clinical practice in medical institutions be focused on.
引文
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[6]满春霞,管晓东,邹武捷,等.我国各省药品集中招标采购政策分析和思考[J].中国卫生政策研究,2016,9(7):53-59.
[7]白飞,李敏奇,陈英耀,等.公立医院临床医师对临床路径实施工作及效果的评价[J].中国医院管理,2017,37(7):1-4.
[2]国家卫生健康委体制改革司.关于印发控制公立医院医疗费用不合理增长的若干意见的通知[EB/OL].(2018-06-08)[2018-10-09]http://www.nhfpc.gov.cn/tigs/s3577/201511/0038da2bf8fe43d69511fb675e205d37.shtml.
[3]于风华.山东省卫生总费用核算研究[D].济南:山东大学,2011.
[4]厉李.我国药品费用的影响因素与控制机制研究[D].沈阳:沈阳药科大学,2009.
[5]牛恒立,李平.药物经济学在临床合理用药中的应用[J].中国医院药学杂志,2008,28(4):308-310.
[6]满春霞,管晓东,邹武捷,等.我国各省药品集中招标采购政策分析和思考[J].中国卫生政策研究,2016,9(7):53-59.
[7]白飞,李敏奇,陈英耀,等.公立医院临床医师对临床路径实施工作及效果的评价[J].中国医院管理,2017,37(7):1-4.