两票制政策对医疗机构药品供应的影响效应研究——以山东省某医院为例  

Effect of Two-vote system on drug supply in medical institutions:a hospital in Shandong as a case study

作　　者：梁轶群 闫美兴 于宝东[1] LIANG Yi-qun;YAN Mei-xing;YU Bao-dong(Qingdao Women and Children’s Hospital Qingdao University,Qingdao Shandong 266034)

机构地区：[1]青岛大学附属妇女儿童医院药学部,山东青岛266034

出　　处：《中南药学》2024年第8期2243-2247,共5页Central South Pharmacy

基　　金：青岛市市级临床重点专科(医院药学)。

摘　　要：目的探讨“两票制”政策对医院药品供应的影响。方法收集2016年11月1日至2022年11月1日期间某医院涨价、降价、涨幅区间、降幅区间品规数,1家及多家配送企业对应品规数,临时及正式转配送品规数,配送企业平均份额及平均品规数,分析“两票制”对药品价格、配送品规数及配送集中度的影响。结果涨价品规数占比逐年下降,降价品规数先减少后增加(P<0.05);涨幅>1000%的品规数占比最大,多数涨幅区间内品规数占比下降;降幅区间内品规数占比变化不明显。由1家配送企业对应品规数占比显著减少,由多家配送企业对应品规数占比明显增加(P<0.05);临时及正式转配送品规数比例均先增加后减少(P<0.05)。配送企业平均份额及平均品规数增加。结论“两票制”对医院药品供应影响显著:抑制大部分药品涨价,但少数药品涨幅突出;药品供货初期不稳定,渐趋改善;药品供应链集中化。建议对涨幅过高品种采取有力措施,进一步减轻患者用药负担。Objective To determine the influence of“Two-vote system”policy on hospital drug supply,and provide reference for policy making.Methods Data from November 1st,2016 to November 1st,2022 were collected,concerning price change in drugs,proportion of changes types and ranges of change delivery and manufacturers,average delivery quota and types,etc.The impact of Two-vote system on drug prices,distribution regulations and drug distribution patterns were analyzed.Results Two-vote system significantly affected drug price(P<0.05).The proportion of price-increase drugs decreased year by year.The percentage of products increased by 1000%was the largest,the rest of product range mostly declined.The change of product gauge was not obvious in the decreasing range.The number of products corresponding to one distribution enterprise decreased(P<0.05),and more than one distribution enterprise increased(P<0.05).The proportion of temporary trans-distribution and formal trans-distribution decreased after the increasing of the regulation(P<0.05).Drug distribution concentration was reflected in the distribution enterprise average share and distribution enterprise average product size centralized.Conclusion Drug supply has been significantly impacted.Price increasing has been controlled,but partial still has been rising sharply.The stability of drug supply has been fluctuated and drug supply chain has been restructured.The optimization and concentration of drug distribution has appeard.Targeted measures with partial drug price increasing should be taken to reduce the burden of drug use for patients.

关 键 词：两票制 医院药品供应 药品价格 配送品规数 药品配送集中度 

分 类 号：R95[医药卫生—药学]