北京市某社区卫生服务中心执行药品集中采购政策后心脑血管药物使用情况分析  

Use of Cardiovascular and Cerebrovascular Agents in a Community Health Center in Beijing after the Implementation of the Pilot Centralized Medicine Procurement and Use Program

作　　者：邱皓 QIU Hao(Xicheng District Changan Community Health Center,Beijing 100031,China)

机构地区：[1]北京市西城区西长安街社区卫生服务中心,100031

出　　处：《实用心脑肺血管病杂志》2021年第8期104-109,115,共7页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：背景近年随着我国医药行业持续、快速发展,药品费用在患者就医成本中占相当大的比重。根据国家统一部署,北京市于2019年率先开展国家药品集中采购和使用试点工作,旨在净化药品流通环境、减轻患者药费负担、深化医药卫生体制改革。目的以北京市某社区卫生服务中心的实践为例,采用定量研究与质性研究相结合的方法分析药品集中采购后心脑血管药物使用情况、药品集中采购政策落实情况,并提出应对措施。方法从某社区卫生服务中心信息管理系统中提取2018年4月—2020年9月(药品集中采购前后30个月)心脑血管药物使用情况的相关数据。记录该社区卫生服务中心药品集中采购前后心脑血管药物情况及降价幅度;采用世界卫生组织推荐的限定日剂量(DDD)分析法分析药品集中采购前1年(2018年4—2019年3月)与药品集中采购后1年(2019年4月—2020年3月)心脑血管药物使用情况,包括各药品品规的用药频度(DDDs)、日均费用(DDC);采用时间序列模型预测药品集中采购目录中心脑血管药物采购量及采购费用变化趋势。采用判断抽样法选取社区卫生服务中心3名全科医生和2名药剂师,根据受访者意愿,采用录音、现场记录及访谈后立刻回忆记录等方式进行访谈,随后对资料进行分类处理。结果该社区卫生服务中心14种心脑血管药物中集中采购目录内药品9种,非集中采购目录内药品5种。集中采购目录内药品中DDDs上升幅度排名前三的是苯磺酸氨氯地平片、厄贝沙坦氢氯噻嗪片、阿托伐他汀钙片(阿乐),分别为531.91%、451.02%、265.43%;非集中采购目录内药品除瑞舒伐他汀钙片(可定)DDDs上升外,其他4种药品DDDs均下降。心脑血管药物DDC下降幅度排名前三的分别是苯磺酸氨氯地平片、氯沙坦钾片、阿托伐他汀钙片(阿乐),分别为-88.14%、-76.67%、-71.60%。间断时间序列模型分析结果显Background Recent years have witnessed a sustained and rapid development in China's healthcare and pharmaceutical industries with considerable large percent of drug costs in patients'healthcare costs.In accordance with the national unified arrangement,Beijing took the lead in carrying out the pilot centralized medicine procurement and use program(PCMPUP)in 2019,so as to purify the environment for drug distribution,reduce the burden of drug costs for patients and deepen the reform of the pharmaceutical and healthcare system.Objective To perform an analysis of the implementation of PCMPUP,and the use of cardiovascular and cerebrovascular agents in a community health center(CHC)in Beijing since the implementation of PCMPUP in April 2019 using quantitative and qualitative approaches,and based on this,put forward relevant responsive measures.Methods Data of cardiovascular and cerebrovascular agents used in a CHC of Beijing for 30 consecutive months(from April 2018 to September 2020)were collected from the hospital information system of the CHC.Analysis was performed on the difference in procurement price of cardiovascular and cerebrovascular agents between April 2018 and March 2019,and between April 2019 and March 2020,as well as the use of each specification of these agents using WHO recommended defined daily dose(DDD)and defined daily cost(DDC).The time series model was used to predict the temporal trend of procurement quantities and costs of cardiovascular and cerebrovascular agents in centralized medicine procurement catalogs.Interviews were conducted with a purposive sample of three general practitioners and two pharmacists selected from the CHC to collect relevant data,and the results were recorded and transcribed,or noted down during the interview and immediately after the interview on the basis of recalling,and then coded,and analyzed using thematic analysis.Results Of the 14 kinds of cardiovascular and cerebrovascular agents in the medicine procurement catalogs of the CHC,nine were purchased using a centraliz

关 键 词：心脑血管药物 药品集中采购 社区卫生服务中心 北京市 

分 类 号：R972[医药卫生—药品]