摘要
目的 全面评价我国药品综合控费的效果,为进一步提升控费效果提供参考。方法 运用熵值法从药价控制能力、药费控制能力、患者负担能力3个维度建立药品控费效果综合评价指标体系,对2016-2020年我国31个省(自治区、直辖市)的药品控费效果进行综合评价,并通过k均值聚类法对我国各省份的综合控费效果进行聚类分析。结果与结论 2016-2020年,我国31个省份药品综合控费效果的综合得分合计值分别为14.64、16.71、17.58、17.57、17.88。聚类分析结果与熵值法排名具有一定的相似性。我国医药卫生体制改革政策在取得阶段性成效之后进入平稳期;31个省份的药品综合控费效果呈现阶梯式特征,沿海经济发达地区和部分西部地区省份的综合控费效果较好,中部地区省份紧随其后,而东北三省效果较差;综合医改试点省份的控费效果提升显著。建议在全国范围内推广综合医改试点地区的成功经验,进一步深化药品带量采购、医保药品价格谈判及按疾病诊断相关分组/按病种分值付费等支付方式改革政策。
OBJECTIVE To evaluate the effects of comprehensive drug cost control in China,and to provide reference for further improving the effects of cost control. METHODS Entropy method was used to establish a comprehensive evaluation index system of the comprehensive drug cost control effect from the respective of drug price control ability,drug cost control ability and patient affordability. The comprehensively evaluate the effects of drug cost control in 31 provinces(autonomous regions and municipalities)during 2016-2020. The k-means cluster method was used to analyze the effects of comprehensive drug cost control in various provinces. RESULTS & CONCLUSIONS During the period of 2016-2020,the total score of comprehensive drug cost control effect of 31 provinces were 14.64,16.71,17.58,17.57,17.88,respectively. The results of cluster analysis were similar to the ranking of entropy method. Medical and health system reform policy had entered a stable period after achieving phased results;the effects of comprehensive drug cost control was characterized by regional steps in 31 provinces;the effects of comprehensive drug cost control were better in developed coastal areas and some provinces and cities of western regions,followed by provinces and cities in central China;however,comprehensive drug cost control in 3 provinces of northeast China showed poor effect. The effects of comprehensive drug cost control in pilot cities of comprehensive medical reform were significantly improved. It is suggested that the successful experience of pilot cities of comprehensive medical reform should be promoted nationwide,and policies such as volume-based drug procurement,medical insurance drug price negotiation,and diagnosis-related groups/diagnosisintervention packet payment method reform should be further deepened.
作者
沈月月
柳鹏程
罗雪燕
齐敏友
袁泉
SHEN Yueyue;LIU Pengcheng;LUO Xueyan;QI Minyou;YUAN Quan(School of Pharmaceutical Science,Zhejiang University of Technology,Hangzhou 310014,China;School of International Pharmaceutical Business,China Pharmaceutical University,Nanjing 211198,China;School of Biological and Chemical Engineering,Chongqing University of Education,Chongqing 400067,China;Chongqing Pharmaceutical(Group)Co.,Ltd.,Chongqing 400010,China)
出处
《中国药房》
CAS
北大核心
2022年第10期1153-1157,1164,共6页
China Pharmacy
基金
重庆市教委科学技术研究项目(No.KJ1901535)
重庆医科大学附属儿童医院儿童医疗保障创新研究示范基地项目(No.NCRCCHD-2019-HP-12)。
关键词
药品综合控费
效果评价
熵值法
聚类分析
comprehensive drug cost control
effect evaluation
entropy method
cluster analysis
