摘要
目的:对当前我国药品集中带量采购政策进行研究剖析,发掘并弥合现阶段药品集中带量采购政策存在的缝隙。方法:以2015年1月~2022年6月发布的药品集中带量采购相关政策为研究对象,基于政策工具、互动主体和三医联动维度构建三维分析框架,使用内容分析法对药品集中带量采购政策文本进行统计分析。结果:对各维度进行交叉分析后共得到312个分析单元总数。政策工具与互动主体维度交叉分析发现:政府层面内容在政策文本中涉及最多,占比68.26%;涉及医疗机构层面的内容次之,占比19.23%;涉及医药企业层面的内容最少,占比12.51%。政策工具与三医联动维度交叉分析发现:政策文本中涉及药品流通层面的内容最多,占比67.30%,涉及医疗机构管理层面的内容次之,占比18.91%;涉及医保支付层面的内容最少,占比13.79%。互动主体与三医联动维度交叉分析发现:政策文本中政府部门涉及药品流通层面的内容最多,占比54.16%;患者涉及药品流通层面的内容最少,占比4.81%。结论:政策工具内部结构不均衡,不同主体参与程度存在差距,“三医联动”维度之间各层次协调性不足;应组合使用政策工具,优化内部框架结构;兼顾各方利益,增强互动主体在活动参与中的主动性;强化各层次主体之间的协调联动能力。
Objective To study the current centralized drug procurement policy in China, and explore the problems in the current centralized drug procurement policy. Methods Based on the related policies of centralized drug procurement issued from January 2015 to June 2022, a three-dimensional analysis framework was constructed based on policy tools, interaction subjects and medicine-insurance-reform linkage, and was statistically analyzed by content analysis method. Results A total of 312 analytical units were obtained by cross-analysis of all dimensions. The cross-analysis of policy tools and interaction subjects showed that government content was most involved in policy texts, accounting for 68. 26%, followed by the contents related to medical institutions, accounting for 19. 23%, and the content related to pharmaceutical enterprises was the least, accounting for 12. 51%. The cross-analysis of policy tools and medicine-insurance-reform linkage dimension showed that the contents related to drug circulation were the most in policy texts, accounting for 67. 30%, followed by the contents related to the management of medical institutions, accounting for 18. 91%, and the contents related to medical insurance payment were the least, accounting for 13. 79%.The cross-analysis of interaction subjects and medicine-insurance-reform linkage dimension showed that government departments involved in drug circulation were the most in the policy texts, accounting for 54. 16%. While the content related to drug circulation among patients was the least, accounting for 4. 81%. Conclusion The internal structure of policy tools was imbalanced.There was a gap among the participation degree of different subjects. And the coordination among different levels of the " medicine-insurance-reform linkage" dimension was insufficient. It is suggested to combine the policy tools to optimize the internal framework structure, take into account the interests of all parties, enhance the initiative of interactive subjects in the activity participation, and stre
作者
常浩然
杨锦茹
胡善菊
武春燕
孙淑慧
Chang Haoran(School of Management,Weifang Medical University,Weifang,P.R.China)
出处
《中国卫生事业管理》
北大核心
2023年第2期122-127,共6页
Chinese Health Service Management
基金
山东省自然科学基金“农村老年残疾人群健康养老社会保障政策整合效果评估与改进”(ZR2020MG062)
山东省社科规划项目“人类命运共同体视阈下中医药传统知识法律治理困境与机制重塑研究”(21CFXJ16)。
关键词
药品集中带量采购
三医联动
政策工具
内容分析法
centralized drug procurement
medicine-insurance-reform linkage
policy tools
content analysis
