我国静脉用药调配中心收费现状与收费标准调研分析

Investigation and analysis of the charging status and standard of pharmacy intravenous admixture service in China

目的调研我国医疗机构静脉用药调配中心(PIVAS)的运营成本和现行收费政策等,为推动静脉用药集中调配工作高质量、可持续发展提供参考。方法2022年5月6日至7月1日,通过“问卷星”平台向全国30个省、自治区和直辖市的医疗机构PIVAS发放电子问卷,调研并分析PIVAS收费现状、运营成本及收费建议。结果全国共有761个PIVAS参与调研,其中属于三级医疗机构的666个,属于二级医疗机构的93个,属于一级医疗机构的2个。60.58%的PIVAS实行了收费制度,其中大多数PIVAS需经过检查评估后方可收费。全国PIVAS总运营成本年均为209.81万元,其中综合运营成本占比高达89.36%,而调配成本仅占10.64%。在各项费用中,人力成本是年均消耗最高的(占比74.20%),然后是房屋装修及维护成本(占比4.77%)、设备仪器购置成本(占比3.44%)。对于各类药物的集中调配费用,普通药物在全国范围内的平均收费标准为4.39元/袋,抗菌药物平均为5.01元/袋,危害药物平均为23.17元/袋,肠外营养液平均为38.75元/袋,而上述4种药物的建议平均收费标准分别为6.71、9.63、38.35、44.03元/袋。结论我国目前尚无统一的检查评估标准和收费标准,且现行收费标准低于建议收费标准,需结合运营成本,制定更加合理和公正的收费标准。

OBJECTIVE To investigate and analyze the operational costs and current charging policies of pharmacy intravenous admixture service(PIVAS)in China,and provide a reference for promoting high-quality and sustainable development of PIVAS.METHODS Questionnaires were distributed in 30 provinces,autonomous regions,and municipalities across the country through the“Wenjuanxing”platform from May 6th to July 1st,2022.The operational costs,charging status and suggestions of PIVAS were investigated and analyzed.RESULTS A total of 761 PIVAS participated in the survey nationwide,including 666 tertiary medical institutions,93 secondary medical institutions,and 2 primary medical institutions.Approximately 60.58%of PIVAS had implemented a charging system that allowed charges.Among them,most PIVAS required inspection and evaluation before charging.The annual operating cost of PIVAS in China was approximately 2098100 yuan,with the integrated operating cost comprising 89.36%of the total,while the dispensing cost accounted for only 10.64%.Human costs emerged as the highest annual consumption(74.20%),followed by decoration and facility maintenance costs(4.77%)and equipment acquisition costs(3.44%).Regarding charges for different drugs nationwide,common drugs had an average charge standard of 4.39 yuan per bag while antibacterial drugs averaged 5.01 yuan per bag;hazardous drugs had an average charge of 23.17 yuan per bag,whereas parenteral nutrition solutions averaged 38.75 yuan per bag.However,the recommended average charges of the four drugs mentioned above were 6.71,9.63,38.35 and 44.03 yuan per bag,respectively.CONCLUSIONS At present,there is no unified inspection and evaluation standard and charging standard in China.Moreover,the current charging standard is lower than the recommended standard.It is necessary to combine operational costs and develop more reasonable and fair charging standards.