某院药品集中带量采购和使用管理探索  

Management of drug volume-based procurement and utilization in a hospital

作　　者：许中 杨世昇 陈一燕[1] 庄志成[1] 弓凯[1] 侯毅翰[1] 林泓纬 陈幼芬[1] Xu Zhong;Yang Shisheng;Chen Yiyan;Zhuang Zhicheng;Gong Kai;Hou Yihan;Lin Hongwei;Chen Youfen(Medical Administration Department,First Affiliated Hospital of Xiamen University,Xiamen 361003,China)

机构地区：[1]厦门大学附属第一医院医务部,361003

出　　处：《中华医院管理杂志》2020年第12期1024-1028,共5页Chinese Journal of Hospital Administration

摘　　要：目的分析某三级公立医院落实国家药品集中带量采购(volume-based procurement,VBP)的管理做法及成效。方法医院构建"上下联动、品类管理、智能监控"的VBP药品多学科协作管理机制,对医院2019年3—12月VBP药品采购数据、患者医药费用、处方换药人次、患者满意率等数据进行分析。结果2019年医院采购任务完成率达186.20%,超额完成采购任务。医院VBP用药频度、日均费用合理,具有良好的社会效应及经济效应,管理模式初见成效。与2018年同期相比,2019年3—12月医院累计医保结余983.3万元,住院次均费用、住院次均药品费用和住院次均医保费用分别下降1.7%、2.6%和2.6%。部分VBP药品存在"二次换药"现象,以心血管疾病相关药品占比大;患者满意度未受影响。结论医院初步建立"上下联动、品类管理、智能监控"的VBP药品管理模式,在完成国家采购任务的同时,为临床治疗需求提供保障。Objective To analyze the management practice and effect of implementing national volume based procurement(VBP)drugs in a tertiary public hospital.Methods The hospital established a multi-disciplinary cooperation management mechanism of VBP drugs with"up and down linkage,category management,business intelligent supervision".The data of VBP drug procurement,patients′medical expenses,prescription dressing change times and patients′satisfaction rate from March to December in 2019 were analyzed.Results In 2019,the completion rate of hospital procurement task was 186.20%,and the procurement task was overfulfilled.The frequency and average daily cost of VBP were reasonable,which had good social and economic effects.The hospital′s accumulated medical insurance balance from March to December in 2019 was 9.833 million RMB;compared with the same period in 2018,the average hospitalization cost,average hospitalization drug cost and average hospitalization medical insurance cost in 2019 decreased by 1.7%,2.6%and 2.6%respectively.Some VBP drugs had the phenomenon of"second drugs substitution",and cardiovascular disease-related drugs accounted for a large proportion.The patient satisfaction was not affected.Conclusions The VBP drug management mode of"up and down linkage,category management,business intelligent supervision"has been initially established in the hospital,which can not only complete the national procurement task,but also provide guarantee for clinical treatment demand.

关 键 词：集体采购 药品集中带量采购 药品品类管理 商业智能监管 

分 类 号：R95[医药卫生—药学]