某医疗机构对国家组织集中带量采购药品的精细化管理及其实践效果

Practice and effect analysis of fine management of rational use of drugs with national centralized procurement in a medical institution

目的通过对国家组织集中带量采购药品(简称:国家集采药品)实施精细化管理,为优化医疗机构国家集采药品的管理模式提供参考。方法围绕国家集采药品合理使用,该院采取了一系列举措,包括建立以患者为中心的用药保障措施、科学测算医疗机构国家集采药品采购量、合同用量科学分配与完成进度实时监测、国家集采药品的临床合理使用管理及建立基于量化指标的使用国家集采药品的激励考核机制。通过计算2020-2022年该院国家集采中标药品的完成比例和使用比例,以及门诊和住院次均药品费用增幅,评价该院对国家集采药品实施精细化管理的效果。结果2020-2022年某院国家集采中标药品完成比例依次为97.67%、98.15%和98.25%,使用比例依次为46.61%、59.00%和92.13%。2020-2022年,门诊次均药品费用增幅依次为40.72%、-15.70%和2.78%,住院次均药品费用增幅依次为29.46%、-8.32%和-10.68%。结论对国家集采药品实施精细化管理,有助于提高国家集采中标药品完成比例和使用比例,降低药品费用,可有效促进医疗机构国家集采药品的临床合理使用。

AIM To promote the implementation of National Centralized Drug Procurement(NCDP)policy in medical institutions through fine management,and to provide reference for optimizing the management mode of drugs with national centralized procurement in medical institutions.METHODS Focusing on the rational use of national centralized procurement drugs,the hospital had taken a series of measures,including establishing patient-centered medication security measures,scientifically calculating the procurement volume of national centralized procurement drugs in medical institutions,scientifically allocating contract volumes and real-time monitoring of completion progress,managing the clinical rational use of drugs related to national centralized procurement,and establishing an incentive assessment mechanism for the use of national centralized procurement drugs based on quantitative indicators.The effect of the hospital's refined management of national centralized procurement drugs was evaluated by calculating the use proportion and completion proportion of selected varieties in the NCDP from 2020 to 2022,as well as the increasing trend of average outpatient and inpatient drug costs.RESULTS The completion rate for the hospital's winning drugs in the NCDP from 2020 to 2022 was 97.67%,98.15%,and 98.25%respectively,and the use proportion was 46.61%,59.00%,and 92.13%respectively.From 2020 to 2022,the increase in drug costs per outpatient visit was 40.72%,-15.70%,and 2.78%respectively,and the increase in drug costs per inpatient visit was 29.46%,-8.32%,and-10.68%respectively.CONCIUSION Implementing precise management of national centralized procurement drugs is helpful to improve the completion ratio and use ratio of national centralized procurement drugs,reduce drug costs,and effectively promote the clinical rational use of national centralized procurement drugs in medical institutions.