总药师制度试点下医疗机构药品收入及结构变动分析--基于Bootstrap的双重差分模型  

Analyzing the Changes of Medicine Income and Structure in Medical Institutions under the Pilot of Chief Pharmacist System Based on Bootstrap Difference-In-Difference Model

作　　者：周怡婷 许永建[1] Zhou Yiting(School of Public Policy and Administration,Xi'an Jiaotong University,Xi'an,P.R.China.)

机构地区：[1]西安交通大学公共政策与管理学院,陕西西安710049

出　　处：《中国卫生事业管理》2022年第11期840-842,847,共4页Chinese Health Service Management

基　　金：国家自然科学基金青年科学基金项目“医药分开背景下公立医疗机构总药师制度实施效果研究”(7180040878)。

摘　　要：目的:总药师制度试点背景下分析医疗机构药品收入及其结构变动.方法:构建干预前后对照比较的准实验研究设计,利用2017和2019年陕西省某市医疗机构年度统计信息,采用基于Bootstrap的双重差分模型进行分析.结果:总药师制度实施后医疗机构门诊中草药收入占比显著增加11.9%(P=0.037),次均门诊药品费用、次均住院药品费用和住院中草药收入占比改变均无统计学意义.结论:作为医药分开改革背景下的一项重要内容,目前该市总药师制度仍处于建设探索初期,政策效果并未凸显,药品结构得以调整但药品收入无明显变化.为促进医疗机构合理用药,提升药事管理水平,需进一步优化制度,完善配套保障措施,推进总药师制度与其他药物制度协同衔接.Objective To analyze the changes of medicine income and medicine structure in medical institutions under the pilot of chief pharmacist system. Methods The quasi-experimental study for comparison before and after intervention was constructed. The data were drawn from annual statistics of medical institutions in one city of Shaanxi Province in 2017 and 2019. And the difference-in-difference model based on bootstrap was employed. Results After the implementation of chief pharmacist system, the proportion of Chinese herbal medicine income in outpatient service of medical institutions significantly increased by 11.9%, while the per time outpatient medicine expense, per time inpatient medicine expense and the proportion of Chinese herbal medicine income in inpatient service had no significant changes. Conclusion As the chief pharmacist system is still in the initial phase, the significant effect has not been obtained. The medicine structure has been adjusted, but the medicine income has not been changed significantly. With the aim of promoting the rational use of medicine and improving the level of pharmaceutical administration, it is suggested to further optimize the chief pharmacist system, develop supplementary measures, and promote the coordination between the chief pharmacist system and other medicine systems.

关 键 词：总药师制度 药品收入 药品结构 BOOTSTRAP 双重差分 

分 类 号：R197.3[医药卫生—卫生事业管理]