四川省78家医疗机构药品短缺情况调查与原因分析
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篇名: 四川省78家医疗机构药品短缺情况调查与原因分析
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摘要: 目的:调查四川省部分医疗机构药品短缺情况及其原因。方法:采取分层随机抽样法,选择四川省78家医疗机构为调查对象进行问卷调查,收集2015年1月-2017年6月期间药品短缺情况,主要包括医疗机构基本信息、药品短缺情况、具体短缺药品信息、药品短缺原因。对调查问卷收集的信息进行描述性分析,并采用SPSS 20.0软件对数据进行Logistic回归分析,找出影响药品短缺的关键因素。结果与结论:78家医疗机构包括三级医院13家、二级医院22家及基层医疗机构43家(社区卫生服务中心10家、乡镇卫生院33家);共发放调查问卷78份,回收率和有效率均为100%;其中68家医疗机构上报了206种短缺药品,合计240个品规;有88.34%以上的短缺药品价格低于50元。短缺药品主要类别为抗感染药物、中枢神经系统药物、心血管系统药物,且多为直接挂网采购类;暂时短缺(短缺时间<3个月)和长期短缺(短缺时间>12个月)的药品占比相对较高(合计占比超过68%);药品供货和医疗机构自身因素是导致药品短缺的两大主要原因。Logistic回归分析显示,影响药品短缺时间的因素主要为医院药品采购流程、医疗机构所处地区以及药品采购价格,影响医疗机构药品短缺品规数的因素主要有药品采购流程、医院采购目录限制、是否基层/非基层医疗机构、是否综合/专科医院。建议该省医疗机构可通过建设短缺药品信息管理平台、优化药品采购目录和计划、加强药房库存管理、建立配送企业监管制度等措施,来减少因自身原因导致的药品短缺现象。
ABSTRACT: OBJECTIVE: To investigate the situation and reasons of drug shortage in some medical institutions from Sichuan province. METHODS: A questionnaire survey was conducted among 78 medical institutions in Sichuan province by stratified random sampling. The situation of drug shortage were collected from Jan. 2015 to Jun. 2017, mainly including the basic information of medical institutions, drug shortage situation, specific drug shortage information and the reasons for drug shortage. Descriptive analysis of the information collected by the questionnaire was carried out, and Logistic regression analysis of the data by SPSS 20.0 software was adopted to find out the key factors affecting drug shortage. RESULTS & CONCLUSIONS: Totally 78 medical institutions include 13 third-level hospitals, 22 second-level hospitals and 43 primary medical institutions (10 community health service centers, 33 township health centers). A total of 78 questionnaires were sent out, and the recovery rate and effective rate both were 100%. Among them, 68 medical institutions reported 206 shortage drugs totally, involving 240 specifications. The prices of more than 88.34% of the shortage drug were less than 50 yuan. Main types of shortage drugs included anti-infective drugs, central nervous system drugs and cardiovascular system drugs, and most of them were purchased directly through internet. The proportion of temporary shortage (shortage time<3 months) and long-term shortage (shortage time>12 months) was relatively high (more than 68% in total). Drug supply and medical institutions’own factors were two main causes of drug shortage. Logistic regression analysis showed that main factors affecting the time of drug shortage were hospital drug purchase process, location of medical institution and drug purchase price. The main factors affecting the specifications of drug shortage in medical institutions were the process of drug purchase, the limitation of hospital purchase catalogue, primary or non-primary medical institution, comprehensive or specialized hospitals. It is suggested that medical institutions in this region can reduce the drug shortage caused by their own reasons by building a platform for drug information management, optimizing drug purchase catalogues and plans, strengthening the management of pharmacy inventory and establishing a regulatory system for distribution enterprises.
期刊: 2019年第30卷第8期
作者: 闫峻峰,于楠,吴姗,任智文,罗维楠,朱昶宇,武航海
AUTHORS: YAN Junfeng,YU Nan,WU Shan,REN Zhiwen,LUO Weinan,ZHU Changyu,WU Hanghai
关键字: 四川省;医疗机构;药品短缺;原因;Logistic回归分析
KEYWORDS: Sichuan province; Medical institution; Drug shortage; Reasons; Logistic regression analysis
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