山西省药品集中招标现状及基层医疗卫生机构药品配送影响因素研究

发布时间：2018-04-28 11:46

本文选题：药品集中招标 + 基层医疗卫生机构　；参考：《山西医科大学》2017年硕士论文

【摘要】：目的:通过对比山西省2015年基本药物集中招标药品中标前后基层医疗卫生机构在采购结算平台中的药品配送供应数据,反映山西省药品集中招标采购的现状,分析基层医疗卫生机构药品供应配送的影响因素,寻找提高基层医疗卫生机构基本药物配送率的有效方法,为完善药品集中采购提供理论依据。方法:运用文献研究法、描述性研究方法,对山西省基层医疗卫生机构2015年基本药物采购数据、2016年基本药物采购数据、山西省2015年基本药物集中招标采购药品双信封指标等数据进行了统计与分析,采用药品配送率作为考察药品供应的指标,揭示了药品集中招标政策对于药品配送率的影响。结果:由于山西省2015年基本药物集中招标采购采用了改进后的双信封招标机制,2015年基本药物集中招标中标产品数量增加,基层医疗卫生机构基本药物用药选择范围大大增加。所有中标产品全部为经济技术标合格产品中的最低价;中标产品的经济技术标平均得分为83.89,高于所有投标产品的平均分81.12;通过改进后的双信封入围规则跟标入围产品的经济技术标平均得分为85.22分,高于最低价直接入围产品的平均分82.48。2016年山西省基层医疗卫生机构基本药物整体的配送率达到了94.94%,相比2015年的83.50%有较大幅度提高,能够较好的满足基层医疗卫生机构的临床用药需求。2016年基层医疗卫生机构短缺药品品种只有19个,相比2015年175个品种短缺大幅减少,绝大部分药品短缺的问题得到了解决。基层医疗卫生机构2016年基本药物网上采购药品配送率与药品的报价(r=0.413,P0.001)、报价水平(r=0.255,P0.001)、采购总量(r=0.343,P0.001)、采购总金额(r=0.600,P0.001)存在正相关的关系。结论:山西省2015年基本药物集中招标采购方案设计科学合理,有效的选择了价格最低且质量较高的产品作为中标产品,并在很大程度上解决了药品短缺问题。药品利润是决定配送率的最主要因素,应当引导或干预企业在获取合理利益的同时必须提高价格低、采购金额小产品的配送率,推动药品供应市场良性发展。对于报价过低的产品应当重点关注配送情况,避免出现短缺问题影响基层医疗机构临床用药。
[Abstract]:Objective: to compare the drug distribution and supply data of primary medical and health institutions in the purchasing and settlement platform before and after the central bidding of essential drugs in Shanxi Province in 2015, so as to reflect the current situation of drug centralized bidding procurement in Shanxi Province. This paper analyzes the influencing factors of drug supply and distribution in primary medical and health institutions, and looks for an effective method to improve the distribution rate of essential drugs in primary medical and health institutions, thus providing a theoretical basis for improving the centralized procurement of drugs. Methods: using the method of literature research and descriptive research, we analyzed the data of essential drugs procurement in primary medical and health institutions in Shanxi Province in 2015 and 2016, respectively. Based on the statistics and analysis of the index of double envelopes of essential drugs in Shanxi Province in 2015, this paper uses the drug distribution rate as the index to investigate the drug supply, and reveals the influence of the centralized bidding policy on the drug distribution rate. Results: because Shanxi province adopted the improved double envelopes bidding mechanism in 2015, the number of products won in 2015 increased, and the selection range of essential drugs in primary medical and health institutions increased greatly. All the winning products are the lowest price in the qualified products. The average economic and technical score of the winning products is 83.89, which is higher than the average score of 81.12 for all bidding products, and 85.22 for the products with the improved double-envelope entry rules. The average distribution rate of essential drugs in primary medical and health institutions in Shanxi Province reached 94.94% in 2016, compared with 83.50% in 2015, compared with 83.50% in 2015. In 2016, there were only 19 kinds of medicines in shortage in primary medical and health institutions, compared with 175 in 2015, the shortage of medicines was greatly reduced, and most of the problems of drug shortage were solved. There was a positive correlation between the drug delivery rate of primary medical and health institutions in 2016 and the quotation level of 0.255g / P0.001N, total purchase amount of 0.343n / P0.001and total purchase amount of 0.600 / P0.001 / r / r ~ (0.600) / P ~ (0.001) / P ~ (0.001) / r ~ (?) / r ~ (0.25) / P ~ (0.001) / P ~ (0.001). Conclusion: the project of central bidding and purchasing of essential drugs in Shanxi Province in 2015 is scientific and reasonable, and the products with the lowest price and higher quality are selected as the winning products effectively, and the shortage of drugs is solved to a great extent. The profit of drugs is the most important factor to determine the distribution rate. It is necessary to guide or intervene the enterprises to increase the distribution rate of small products in order to promote the healthy development of the drug supply market while obtaining reasonable benefits. In order to avoid the shortage of drugs in primary medical institutions, we should focus on the distribution of products with too low price.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R95

【参考文献】