小康型乡镇卫生院药品配送模式的探索及应用

Exploration and application of drug delivery model in well-off level township hospitals

目的建立小康型乡镇卫生院药品配送模式并进行应用验证。方法针对药品配送模式的拟定、筛选、运行、应用等,采用文献分析、定性访谈、焦点小组讨论和专家咨询的方法收集有关情报和咨询意见,筛选出乡镇卫生院-村卫生室代购模式进行初步应用。结果模式实施后,双流县永安中心卫生院业务总收入呈上升趋势,基本药物销售金额占医院药品收入的95.6%,单处方金额下降51.37%,药品比例下降13.38%,门诊均次费用为60.5元低于本地其他中心卫生院;所辖村卫生室就诊人次、整体收入增加。结论制订制度、规范流程是保证药品品质、降低药品价格的关键;加强对村卫生室的监管是保证基层网底用药质量的核心;乡镇卫生院-村卫生室代购模式适用于乡村一体化管理较健全、信息化程度较高的地区,能有效提升药品质量,降低药品比例,提高村站就诊人次,促进农村患者就近、就早看病。

Objective To establish and validate the drug delivery model in well-off township hospitals. Methods A purchasing agency model based upon drag delivery patterns, screening, running and applications was screened out by using methods including literature analysis, qualitative interview, group discussion and expert consultation. In order to demonstrate its validation, the model was preliminarily applied in a township health center-village clinic. Results After implementation of the model, the total income of the Yong＇an township center hospital was raising and amount of the basic drug sales were 95.6% of all drug sales. However, single prescription fee was declined by 51.37% and drug proportion was reduced by 13.38% , and outpatient service charges are 60.5 yuan that was lower than other local township central hospitals. Meanwhile, number of patients and income in the village clinic was increased. Conclusion System formulation and process standardization is a key for quality of drugs and reduction of drug prices. Strengthening the supervision of village health clinics is the core to ensure the drug quality at the end of basic network. The model may be used to areas in which rural integrated management is more perfect and there is high degree of information technology. It can effectively improve the quality of drugs, reduce drug proportion and increase village clinic visits. As a result, rural patients may see a doctor easer and earlier.