我国医疗联合体上下用药衔接的困境分析及对策建议

The Predicament Analysis and Countermeasures of Pharmacy Coherence among the Upper and Lower Institutions in China’s Medical Consortium

目的:针对目前我国医疗联合体上下用药衔接存在的困境进行分析,并提出对策建议。方法:对分级诊疗制度和医疗联合体建设信息上报平台监测数据信息进行描述性统计分析,对实地调研内容进行文本分析,提出我国医疗联合体上下用药衔接工作中面临的困境。结果:能够执行上下用药衔接相关政策要求的医疗联合体数量占比较低,县域医疗联合体的政策执行情况好于城市地区。医疗联合体内上下用药衔接主要面临着用药目录统一困难、区域统一的流通配送链条尚未完善、医疗保险和药品监督外部政策衔接不畅、对上下用药衔接的认知不统一等困难。结论:要进一步做好紧密型医疗联合体内药品供应保障各项政策衔接;发挥牵头医院作用,做好药事管理体系和制度建设,加强药学服务能力建设,加强患者用药信息的上下联通等。

Objective:To propose countermeasures and suggestions for the current predicament of pharmacy coherence among the upper and lower institutions in China’s medical consortium.Methods:Based on the statistical analysis monitoring data on Hierarchical Diagnosis System and the medical alliance construction,the text analysis was conducted on the base of field research interviews and cases,the predicament of pharmacy coherence among the upper and lower institutions in China’s medical consortium was raised.Results:The proportion of compact medical consortia which carried out policy requirements of pharmacy coherence was relatively low,and the policy implementation was better in towns than that in cities.The major quandaries include the difficulties of unifying medication catalogue and regional logistics,the limitations of medical insurance and drug administration policies,and the insufficient awareness of pharmacy coherence.Conclusions:Based on the practical experience in those areas,it is necessary to coordinate the policy of drug supply in compact medical consortia.The leading hospitals should establish the pharmaceutical management system and develop related rules and regulations,strengthen the capacity of pharmaceutical care,and implement shared medication information of patients among the institutions in the consortia.