浙江省医疗机构药房托管前后运行状况分析

Analysis of the Operation of the Hospital Pharmacies before and after the Implementation of the Trusteeship Mode in Zhejiang

目的:分析讨论浙江省医疗机构药房托管后,在医疗机构效益、药品价格、用药量、采购额以及库存量等方面的变化与相关影响,为医药卫生体制改革、医药分业制度的实施提供科学依据。方法:从已经实施托管的二十多家医疗机构中随机抽取4家,对其托管前后的药品价格、医疗机构收益、运营成本、医疗机构药占比、用药量等指标进行对比分析,评价医疗机构药房托管后的运行现况。结果:实施托管后,在医疗机构用药量、采购量及药品库存量上,各医疗机构包括二、三级医疗机构及社区卫生服务中心均有增幅,但用药量增幅基本低于采购量、库存量;药品平均采购周期上各医疗机构比托管前均有大幅缩短;各医疗机构收益均呈增长趋势,单药占比均呈下降趋势,单处方药费也呈下降趋势。结论:医疗机构药房托管后,医疗机构和药房的收益增加,运行效率提高,药价下降,客观上可以促进改变以药养医的传统模式,减轻患者的用药费用负担,从而实现市场经济下医疗机构、企业及患者在社会与经济效益上多赢的局面。

Objective： Discussion on the influence of hospital pharmacy trusteeship after the implementation of hospital benefit, the price of drugs has dosage, and provide scientific basis for the implementation of medical system reform, medical separation system. Methods： Before and after the implementation of hospital pharmacy trusteeship selected sample of custody of the drug price, hospital income, operating costs, the hospi- tal drugs proportion, in hospitalized patients were compared and analyzed with dosage and other indicators, the evaluation of pros and cons of has- pital pharmacy trusteeship after application. Results： Implementation of the trust, a three level of hospital drug volume growth of 5.17%, than the trusteeship of the two hospitals; a three level of hospital drug purchase amount increased than before, community health service center; hospi- tal drug inventory growth than the trusteeship of the two hospitals growth in community health service center; hospital drug procurement cycle to sho^en the average level of a level three hospital than managed before; income of community health service center, three grade hospital showed a tendency of increase, single drug proportion decreased, the level three hospital decreased. Conclusion： The implementation of the trust can not only enhance the hospital and pharmacy benefits and efficiency of hospital pharmacy, and can effectively change the traditional mode to take the medicine, reduce patient burden of medical expenses.