药品价格监测管理政策对医疗机构的影响研究  

Study on the Impact of Drug Price Monitoring and Management Policy on Medical Institutions

作　　者：唐弦 王静翠 何昆 常壤丹 武志昂 唐晓蓉 胡明[1] Tang Xian;Wang Jingcui;He Kun;Chang Rangdan;Wu Zhiang;Tang Xiaorong;Hu Ming(West China School of Pharmacy,Sichuan University,Chengdu 610041,China;Bidding&Purchasing Service Center for Drugs&Medical Devices of Sichuan Province,Chengdu 610016,China;Yeehong Business School,Shenyang Pharmaceutical University,Beijing 100055,China)

机构地区：[1]四川大学华西药学院,成都610041 [2]四川省药械招标采购服务中心,成都610016 [3]沈阳药科大学亦弘商学院,北京100055

出　　处：《中国药事》2024年第9期1076-1085,共10页Chinese Pharmaceutical Affairs

摘　　要：目的:调查了解医疗机构实施药品价格监测管理的现状,了解医务人员对“红黄绿”监测等药品价格监管措施的认知及态度,为规范和完善药品价格监测管理提供参考。方法:对样本医疗机构开展问卷调查,对相关人员进行半结构化访谈,在描述性统计分析基础上对不同等级医疗机构实施差异等进行推论统计学分析。结果:问卷调查共收回25家医疗机构370份医护药受访者有效问卷。76.8%受访者认为当前的药品价格呈现稳定至下降趋势,降价幅度方面三级医疗机构的感知大于二级医疗机构(P=0.034)和二级以下医疗机构(P=0.005);医务人员普遍认为药品价格监管政策对其处方行为产生一定影响,主要影响政策有“药占比”(n=323,87.3%)、“集采”(n=294,79.5%)和“基药”(n=294,79.5%);医务人员开具处方时优先考虑因素有“临床效果”(n=178,48.1%)和“药品价格”(n=147,39.7%);访谈显示医疗机构药品管理人员对“红黄绿”监测规范的理解尚不到位,部分医疗机构未建立完整透明的内部管理制度。结论:药品价格控制政策实施有效,维护了药品市场的合理价格并促进医疗机构合理用药。但不同药品监管政策的冗杂对医生处方行为有一定限制影响,建议不同政策间应做好落地协调与细化,医疗机构建立透明价格监测体系,加强医务人员培训。Objective:To investigate the current situation of the medical institutions to implement the drug price monitoring and management,and to understand the awareness and attitude of medical staffs towards RedYellow-Green monitoring and other pharmaceutical price regulation measures,in order to provide reference for standardizing and improving drug price monitoring and management.Methods:A questionnaire survey was conducted in the sample medical institutions,and semi-structured interviews were conducted with relevant personnel.On the basis of descriptive statistical analysis,inferential statistical analysis was conducted on the implementation differences of medical institutions at different levels.Results:A total of 370 valid questionnaires were collected from 25 medical institutions.Among which,76.8%of the respondents believed that the current drug prices showed a stable to declining trend,and the perception of the price reduction rate of tertiary medical institutions was greater than that of secondary medical institutions(P=0.034)and sub-secondary medical institutions(P=0.005).Medical staff generally believed that the drug price regulation policy had a certain impact on their prescription behavior,mainly affecting the proportion of drug proportion(n=323,87.3%),centralized procurement(n=294,79.5%)and basic drugs(n=294,79.5%).Clinical effect(n=178,48.1%)and drug price(n=147,39.7%)were the priority factors for medical staff to prescribe.The interviews showed that the drug management personnel of medical institutions did not have a proper understanding of the Red-Yellow-Green price monitoring policy,and some medical institutions had not established a complete and transparent internal management system.Conclusion:The drug price control policy has been effectively implemented,maintaining reasonable prices in the drug market and promoting rational drug use in medical institutions.However,the complexity of different drug regulatory policies has a certain limiting effect on doctors'prescribing behavior.It is suggested that di

关 键 词：药品价格监测 问卷调查 医疗机构 “红黄绿”药品价格监测政策 处方行为 

分 类 号：R95[医药卫生—药学]