医药分开改革评价的逻辑模型构建与应用

The Logical Model of the Separation of Drug Prescribing and Dispensing

全国的医药分开改革至2017年已基本完成。但城市之间、城市与县级公立医院间改革路径与内容差异较大,不同的改革路径和评价模式会产生不同的结果。有必要建立概念性的评价框架,展示改革中的逻辑关系和因果链条,为诊断问题和规范研究提供基础。本研究以北京的医药分开改革内容为主体,植入政策评价模型的基本要素,结合卫生系统绩效评价指标,构建了医药分开改革评价的逻辑模型,为评价改革提供了系统的分析框架,为后续医耗联动改革提供评价基础。

The separation of drug prescribing and dispensing had been basically completed by 2017. However, there were great differences in reform paths and contents among public hospitals of cities and towns. Different reform paths and evaluation models would produce different results. It was necessary to establish a conceptual evaluation framework, show the logical relationship and causal chain in the reform, and provide a basis for diagnosis and normative research. The paper took Beijing’s reform as a case, implanted the basic elements of the policy evaluation model, and combined the health system performance evaluation indicators;it constructed a logical model of policy evaluation and provided a systematic analysis framework for evaluation reform, so as to provide evaluation basis for further medical consumable reform.