我国基层医疗卫生机构药品“零差率”政策实施现状及问题文献分析

Literatural Analysis of the Implementation and Problems of Zero Profit Drug Policy in Primary Health Institutions in China

目的:了解我国基层医疗卫生机构药品"零差率"政策的实施现状、效果及存在的问题。方法:采用文献研究法,设定文献纳入/排除标准,制定文献检索策略并进行文献检索,将检索到的文献进行初步筛选和质量评价,对符合要求的文献进行重点信息摘录、综合分析并得出结果。结果:药品"零差率"政策实施后,药品价格下降幅度较大,基层医疗卫生机构门诊人/次数上升,次均处方的药品数量和费用下降;同时,该政策还存在不规范方面,如地区间发展不平衡、"零差率"药物种类较少、药品价格仍然虚高、政府补偿不足、"零差率"药品断货等。结论:在评价药品"零差率"政策实施效果时,设计较为严谨的研究未被发现;药品"零差率"政策评价指标体系尚未建立;居民对"零差率"政策认知方面的研究较少;对药品"零差率"政策的实施监管及控制的研究较少;对于"零差率"目录以外的药品是否应该销售的研究基本上没有涉及;如何建立完善的药品供应体系需要进一步研究。

OBJECTIVE：To probe into the implementing effect of zero profit drug policy in primary health institutions and the problems in the course of implementation.METHODS：By literature study method, inclusion criteria were set up to retrieve relevant literatures.Preliminary screening and quality evaluation of literatures retrieved were carried out.Important information of included literatures had been extracted and analyzed comprehensively.RESULTS：After the implementation of zero profit drug policy, the number of out-patient visits in community health service institution increased while prescription charge per time decreased significantly.There were still some problems, such as incomplete supporting policy, imperfect government investment mechanism, out of stock of zero profit drugs.CONCLUSION：More precise study is not adopted to evaluate implementing effect of zero profit drug policy.The index evaluation system of zero profit drug policy has not been set up.Research of zero profit drug policy hardly involves the cognition and attitude of residents, control and supervision of the implementation of zero profit drug policy.Research of primary health institutions is basically not involve whether drugs excluded from Zero Profit Drug List for Community Health Service Institutions sale or not.The establishment of perfect drug supply system needs further study.