某儿童医院药品临时采购问题及对策研究  

Problems and Countermeasures of Temporary Drug Purchase in a Children’s Hospital

作　　者：刘丹 沈双双 李浩 张顺国[1] LIU Dan;SHEN Shuangshuang;LI Hao;ZHANG Shunguo(Department of Pharmacy,Shanghai Children’s Medical Center,Shanghai Jiao Tong University School of Medicine,Shanghai,China 200127;China Institute for Urban Governance,Shanghai Jiao Tong University,Shanghai,China 200030;Child Health Advocacy Institute,China Hospital Development Institute,Shanghai Jiao Tong University,Shanghai,China 200127)

机构地区：[1]上海交通大学医学院附属上海儿童医学中心药剂科,上海200127 [2]上海交通大学中国城市治理研究院,上海200030 [3]上海交通大学中国医院发展研究院儿童健康管理研究所,上海200127

出　　处：《中国药业》2021年第16期14-17,共4页China Pharmaceuticals

基　　金：上海交通大学中央高校基本科研业务费资助项目[17JCYB11];上海交通大学上海市“十四五”规划平行研究课题[面上项目];上海交通大学中国医院发展研究院2019年度医院管理建设项目(面上项目)[CHDI-2019-B-17];2019年上海市“医苑新星”青年医学人才培养资助计划[沪卫人事[2020]87号]。

摘　　要：目的为构建我国医疗机构药品临时采购管理模式提供参考。方法收集上海交通大学医学院附属上海儿童医学中心2009年1月至2020年10月临时采购药品的信息,依据《陈新谦新编药物学(》第18版)对药品进行药理学分类,结合医院药品供应目录,综合分析临时采购药品的主要用途、医保药品和国产药品分布、年增长采购情况、不合理(含疑似不合理)采购情况。结果2009年至2020年,该院临时采购药品1620次,以抗感染药(24.57%)和抗肿瘤药(20.68%)为主;涉及159个品种,以抗感染药为主(26.42%)。2016年和2019年月均采购频次均较前一年显著增长。采购药品中医保药品占83.98%,国产药品占53.03%。采购院内供应同一通用名、同种规格的药品共32次,占总采购次数的1.95%。约10%的药品临时采购疑似不合理。发现医院药品临时采购中存在的共性问题,包括缺乏明确的法律规范、流程烦琐、缺乏事前科学论证、采购渠道受限。结论该院药品的临时采购过程中存在较多问题,需进一步加强管理。建议制订医疗机构药品临时采购的相关规定,利用信息化手段简化流程,建立合理的判定评价标准,并扩大采购范围。Objective To provide a reference for the construction of the management model for temporary drug purchase in medical institutions in China.Methods The information of temporary drug purchase in the Shanghai Children’s Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine from January 2009 to October 2020 was collected.The drugs were pharmacologically classified according to the New Materia Medica(18 th Edition),and the main uses of temporarily purchased drugs,the distribution of medicare drugs and domestic drugs,the annual growth of procurement and unreasonable(including suspected unreasonable)procurement were comprehensively analyzed based on hospital drug supply catalog.Results From 2009 to 2020,there were 1620 times of temporary drug purchases in the hospitals,mainly anti-infective drugs(24.57%)and anti-tumor drugs(20.68%).A total of 59 drug varieties were involved in the purchased drugs,mainly anti-infective drugs(26.42%).The frequency of procurement in 2016 and 2019 increased significantly compared with that in the previous year.Precisely 83.98%of the purchased drugs were medicare drugs,and53.03%were domestic drugs.A total of 32 times of temporary drug purchases was associated with the same generic name and same specification,accounting for 1.95%of the total procurement times.About 10%of the temporary drug purchase was suspected to be unreasonable.It was found that there were common problems in hospital temporary drug purchase,including lack of clear legal norms,cumbersome process,lack of prior scientific demonstration and limited procurement channels.Conclusion There are many problems in the process of temporary drug purchase in the hospital,which need to be further managed.It is suggested to formulate relevant regulations on temporary drug purchase in medical institutions,use information-based means to simplify the process,establish rationality judgment and evaluation standards,and expand the scope of purchase.

关 键 词：儿童医院 药品 临时采购 药事管理 

分 类 号：R95[医药卫生—药学]