医疗机构落实药品集中带量采购政策中的问题及建议

Problems and suggestions in the implementation of drug centralized volume-based procurement policies in the hospitals

目的探讨医疗机构实施药品集中带量采购(以下简称集采)政策过程中面临的问题,并提出相应的优化建议。方法基于德尔菲法,于2023年8—12月,通过立意抽样选取全国11名三级甲等医院药学专家进行调查研究,调查内容为"推进国家药品集采提速扩面、集采医保资金结余留用的相关政策建议"。结果调查参与者反馈了医疗机构在药品集采政策实施中存在的系列问题,并提出了相应的优化方法。专家咨询的肯德尔和谐系数为0.332(P<0.05),表明专家意见具有较好的一致性和集中性。其中,关于药品供应保障问题的赋分最高(重要性均数为4.45分),同时对于加强监测预警和协调调度,切实保障集采药品供应的建议赋分最高且集中程度最高(重要性均数为4.91分,变异系数为0.06)。结论本研究通过德尔菲法调查揭示了医疗机构实施药品集采中的问题并提出优化方法,对于医药领域实施的改进和未来政策调整具有一定的参考价值。

Objective To explore the challenges in the implementation of drug centralized volume-based procurement policies in hospitals and propose corresponding optimization suggestions.Methods From August to December 2023,a purposive sampling was conducted to select 11 pharmaceutical experts from tertiary hospitals in China for Delphi method.The survey content included"policy recommendations for promoting the acceleration and expansion of national drug centralized procurement and retaining surplus medical insurance funds for centralized procurement".Results Survey participants gave feedback on a set of existing problems found in the implementation of drug centralized procurement policies and proposed corresponding optimization methods.Kendall′s W coefficient of the specialist consultation was 0.332(P<0.05),demonstrating good consistency and concentration of the expert opinions.Among the problems,the score of drug supply guarantee was the highest(mean value of importance was 4.45).At the same time,the recommendation of strengthening monitoring and early warning,coordination and dispatch,and effectively ensuring the supply of centralized drug procurement had the highest score and concentration(mean value of importance was 4.91,coefficient of variation was 0.06).Conclusions Through Delphi method,this study revealed issues and optimization methods in the implementation of drug centralized procurement policies in hospitals.The findings could provide valuable insights for improvements in the pharmaceutical sector and future policy adjustments.