我国中西部三省(自治区)贫困边远地区农村基层医疗卫生机构基本药物采购供应情况  

The procurement and supply of essential medicines in rural primary medical institutions in poor or remote areas of three provinces(autonomous regions) in central and western China

作　　者：王文杰 李琛 肖琳琪 张欲晓 方欣 崔丹 殷潇 毛宗福 WANG Wen-jie LI Chen XIAO Lin-qi ZHANG Yu-xiao FANG Xin CUI Dan YIN Xiao MAO Zong-fu(School of Health Sciences,Wuhan University,Wuhan Hubei 430071,China）.)

机构地区：[1]武汉大学健康学院,湖北武汉430071

出　　处：《中国卫生资源》2017年第6期485-489,共5页Chinese Health Resources

基　　金：国家卫生计生委药政司委托项目(药政[2016]12号;药政[2016]14号);国家教育部人文社科青年项目(17YJC630220)

摘　　要：目的 :了解我国中西部湖北、广西、江西贫困边远地区农村基层医疗机构的基本药物配送供应情况。方法 :采用典型抽样法,经当地推荐和专家遴选后,在湖北、广西、江西抽取6个有代表性的贫困县,对其70家乡镇卫生院及其代购的村卫生室基本药物采购情况进行现场调查。根据药物采购监管平台数据,对其基本药物的采购品种占比、采购金额占比、目录采购率、配送入库率和短缺等指标进行分析,采用SAS 8.0进行统计分析,包括频数、率和构成比的统计描述。结果 :湖北、广西、江西样本农村基层医疗机构药物采购中基本药物占比较高;基本药物整体配送率较高,3 d到货在实际配送中尚不能完全实现,存在部分药物不配送和配送不及时等短缺情况,且集中表现为流通性短缺。结论 :基本药物的配送率与中标价格、配送费率有关。应健全药物短缺监测体系建设,理清"真性短缺",科学评估生产配送企业的服务能力,打包配送并进行考核和监管,引入第三方物流保障药物配送。ObjectiveTo understand the situation of the delivery and supply of essential medicines in rural primary medical institutions in poor or remote areas of central and western China such as Hubei,Guangxi and Jiangxi. Methods：Typical sampling method was used. A total of 70 township health centers from six poor counties in Hubei,Guangxi and Jiangxi were selected to conduct site investigation. Data from hospital information system and medicine procuring and monitoring platform were analyzed,including the proportion of the types and amount of the procured essential medicines,the distribution and delivery rates,and shortage,etc. SAS 8.0 was used to statistically describe the frequency,rate and ratio. Results：The essential medicines accounted for a relatively high proportion of the drugs procured by sample rural primary medical institutions in Hubei,Guangxi and Jiangxi. The distribution rate of essential medicines was relatively high,but the three-day arrival rate was low in Hubei,Guangxi and Jiangxi. There was still some shortages such as the lack of distribution and late delivery,which were shown as circulation shortages. Conclusion ：The distribution rate of essential medicines is related to bid price and delivery fare rate. It is suggested to optimize the monitoring and reporting platform for drug shortage,clarify ‘true’ shortage,scientifically evaluate the production and distribution capabilities of service enterprises,distribute drugs in package with assessment and supervision,and introduce third-party logistics service provider to guarantee drug distribution.

关 键 词：农村基层医疗卫生机构 基本药物 供应保障 配送入库率 短缺 

分 类 号：R197.62[医药卫生—卫生事业管理] R95[医药卫生—公共卫生与预防医学]