国家基本药物短缺风险评价指标体系的构建研究

发布时间：2018-06-26 05:14

本文选题：国家基本药物 + 短缺　；参考：《北京中医药大学》2017年硕士论文

【摘要】：目的:基于系统思想和供求理论,从国家基本药物供应链流程出发,详细分析影响基本药物短缺的风险因素,筛选基本药物短缺风险指标,并确定指标权重,最终建立起基本药物短缺风险评价指标体系,为定量评估基本药物短缺风险大小提供支撑,为建立基本药物短缺风险预警体系奠定基础。方法:(1)基本药物短缺风险因素界定及指标初筛方法,主要采用文献研究和专家访谈法,通过前期文献研究,对国内外研究基本药物短缺成因的文献进行梳理,同时访谈基本药物生产企业、经营配送企业、医疗机构、卫生行政部门中高层管理人员共8人,听取一线工作人员的具体意见后,科学、全面的分析影响基本药物短缺的供应链各环节风险因素,在此基础上,对相关法规文献进行二次梳理,找出影响基本药物短缺的具体指标,并对其合理归类。(2)指标评价方法,主要采用德尔菲法,按照参与意愿高、经验丰富、短缺各风险领域全覆盖的原则,选取药品生产企业、药品经营配送企业、医疗机构、卫生行政部门具有中高级职称的管理人员共13人作为咨询专家。通过电子邮件发放问卷的形式,实施两轮咨询,以建立起基本药物短缺风险评价指标体系。(3)权重确定方法,主要采用层次分析法,通过构造层次分析矩阵,根据专家打分情况,计算出各评价指标的具体权重。结果:(1)基本药物短缺风险因素涉及到基本药物的生产、经营配送、临床配备使用、政府管理、患者消费等供应链的各个环节,其中生产、临床配备使用及政府管理是影响基本药物短缺风险的关键因素。(2)经过两轮咨询后,构建的基本药物短缺风险评价指标体系包括生产、经营配送、使用、政府4个一级指标,13个二级指标,45个三级指标。同时经过层次分析处理,结果显示权重较大的一级指标包括使用(W使用=0.3423)、政府(W政府=0.3028)、生产(W生产=0.261),是影响基本药物短缺的主要因素。结论:为了提高基本药物短缺干预效力,保障基本药物供应市场的稳定运行,应逐步建立基本药物短缺风险预警机制,优化基本药物全供应链监管,鼓励利益相关方共同参与形成监管合力。
[Abstract]:Objective: based on the theory of system and supply and demand, the risk factors affecting the shortage of essential drugs were analyzed in detail, and the risk index of the shortage of essential drugs was selected and the weight of the indexes was determined. Finally, the evaluation index system of essential drug shortage risk is established, which provides the support for the quantitative evaluation of the risk of essential drug shortage, and lays the foundation for the establishment of the risk warning system of essential drug shortage. Methods: (1) the methods of defining the risk factors of essential drug shortage and screening the index, mainly by literature research and expert interview, through the previous literature study, to comb the domestic and foreign literature on the causes of the shortage of essential drugs. At the same time, they interviewed eight senior management personnel in basic drug production enterprises, distribution enterprises, medical institutions, and health administration departments, and listened to the specific opinions of front-line staff. On the basis of comprehensive analysis of the risk factors in supply chain which affect the shortage of essential drugs, this paper makes a second combing of the relevant laws and regulations, finds out the specific indicators that affect the shortage of essential drugs, and classifies them reasonably. (2) the evaluation methods of indicators. Mainly using Delphi method, according to the principle of high willingness to participate, rich experience and full coverage of various risk areas of shortage, drug production enterprises, drug trading and distribution enterprises, and medical institutions are selected. The health administration department has the middle and senior title management staff altogether 13 people as the consultation expert. In order to establish the evaluation index system of the shortage risk of essential drugs, two rounds of consultation are carried out through the form of email questionnaire. (3) the method of determining the weight is mainly used in AHP, through constructing the AHP matrix, according to the situation of experts' scoring, Calculate the specific weight of each evaluation index. Results: (1) the risk factors of the shortage of essential drugs are related to the production, management and distribution of essential drugs, clinical equipment use, government management, patient consumption and so on. Clinical use and government management are the key factors affecting the risk of essential drug shortage. (2) after two rounds of consultation, the evaluation index system of essential drug shortage risk includes production, management, distribution and use. The government has 4 first-level indicators, 13 second-level indicators and 45 third-level indicators. At the same time, the results showed that the main factors affecting the shortage of essential drugs were the use of 0.3423, the government (0.3028) and the production (0.261). Conclusion: in order to improve the effectiveness of the essential drug shortage intervention and ensure the stable operation of the essential drug supply market, we should gradually establish the risk warning mechanism of the essential drug shortage and optimize the supervision of the whole supply chain of essential drugs. Stakeholders are encouraged to participate in the formation of regulatory synergies.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R95

【参考文献】