西部贫困地区县、乡、村三级医疗机构药品购销体制与合理用药分析

Analysis on Medicine Purchase-sale System in 3-level Medical Institutions and Rational Use of Medicine in Western Poverty Areas

目的探讨县级医疗机构药品集中招标采购、乡村两级医疗机构药品统一管理体制对药品合理使用的影响。方法运用快速评价法、描述性统计方法分析西部贫困地区三级医疗机构药品购销体制与合理用药之间的关系。结果尽管西部贫困地区农村医疗机构药品购销体制存在一些问题,但是县级医疗机构药品集中招标采购以及乡村两级卫生组织一体化管理确保了药品使用的安全性、经济性,极大地促进了药品的合理使用。结论西部贫困地区应改革农村医疗机构的补偿机制,分阶段、有步骤地实行"医药分开";县级医疗机构净化药品集中招标采购的关键环节,乡、村两级医疗机构依托乡村卫生组织一体化管理,完善药品统一代购体制,促进合理用药。

Objective To analyze thoroughly the significant meanings of mass advertised bidding in county level and the integrated management of village medical institutions on rational use of medicine. Methods Rapid evaluation method and descriptive study were used to analyze the relations between the purchase - sale system and the rational use of medicine in 3 - level medical institutions in western poverty areas. Results There were some problems in rural medical institutions, while it could ensure the drug safety, economy and improve the rational use of medicine by implementing mass advertised bidding and the integrated management. Conclusions In western poverty areas, it should do some innovations on the compensation mechanism to realize treatment - medicine separated step by step. It can improve rational use of medicine through the mechanism of mass advertised bidding in county level and the integrated management of village medical institutions.