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1.
制定国家基本药物政策的重要意义   总被引:5,自引:0,他引:5  
石嬿  龚勋 《卫生软科学》2008,22(1):66-67
国家基本药物政策制定和尽快出台对规范药物合理使用、建立可持续性的药品筹资机制、药品供应系统的建立,提高药品的可负担性、加强药品管理等有着极其重要的意义.本文着重从解决看病难、看病贵等紧迫问题探讨制定国家基本药物政策的现实意义.  相似文献   

2.
目的:为完善基本药物筹资政策提供信息和依据。方法:通过综述和理论研究建立研究模型、提出研究假设,以3县9个卫生院获取的定量和定性证据来验证相关假设。结果:基本药物筹资政策、其他基本药物制度和非正式规则联合作用会改变乡镇卫生院的筹资和激励结构,最终影响乡镇卫生院的筹资行为和应对策略;同时,非正式规则的地方性差异会导致基本药物筹资行为的多样性。建议:加大政府补助,形成良性的筹资和激励机制;以乡镇卫生院的功能为基础采取措施适当增加药品品种;适当扩大新农合基金的报销范围;建立监测与督导机制,提高乡镇卫生院采用非正式规则的预期成本。  相似文献   

3.
国家药物政策的关键元素包括基本药物的遴选、促进药物合理使用、建立可持续性的药品筹资机制、药品供应系统的建立、提高药品的可负担性、加强药品管理、加强人力资源开发、加强药品的研究、加强监测和评估;国家药物政策的关键元素与药品政策目标密切相关;作者还详细介绍了评价药物政策关键元素的有关指标,并对有关元素进行了分析.  相似文献   

4.
通过对国际基本卫生服务筹资经验的总结,发现更多的国家采用了公共筹资机制和以税收为主的筹资模式,在此基础上对部分发展中国家的资金筹集、分配和使用进行分析,总结各国基本卫生服务筹资的经验和教训,为在我国建立充足、公平、高效和可持续的基本卫生服务筹资制度提供参考和依据  相似文献   

5.
通过对国家基本公共卫生服务项目进行面上调查和典型地区调查发现,国家基本公共卫生服务项目已经建立了完善的组织管理体系、明确的分工协作机制和稳定的筹资增长机制,服务内容不断丰富,服务提供更加精细化,居民获得感得到提升。建议进一步完善相关政策,建立以需求为导向的基本公共卫生服务项目动态调整机制;研究以成本为基础的服务标准测算方法并制定操作手册;提供精细化与个性化服务;加快发挥智慧化手段的助力作用。  相似文献   

6.
目的:围绕乡镇卫生院执行国家基本药物制度面临的筹资困难问题,研究乡镇卫生院筹资测算技术方法,以服务决策、完善政策设计。方法:以S县乡镇卫生院筹资为个案,进行测算技术方法的研究。资料来源于2009年S县卫生财务年报数据库,并开展了关键人物访谈。结果:S县乡镇卫生院因取消药品加成减少2317万元收入,为弥补这一损失,经测算,财政补助收入和医疗服务收入分别需新增719万元和1598万元。为此,S县医疗服务数量若增长10%,则需将医疗服务价格提高40%。结论:实行基本药物制度并得到补偿后,整个社会福利得到改进;卫生筹资和经济补偿得到优化;地方政府财政供给能力面临挑战。建议:建立政府补助为主导的筹资机制;逐步提高新农合筹资水平;适当提高乡镇卫生院医疗服务收费水平。  相似文献   

7.
陈竺部长在2009年全国医药卫生工作会议上强调,要“加快’建设国家基本药物制度,为人民群众提供安全有效、质优价廉的药品”。当前我国面临着建立国家基本药物制度的最佳时机,政府应当以此为契机,抓住药物遴选、生产、流通、定价、使用五大环节的机制建设,做好基本药物制度试点工作,不断总结完善经验,稳步推进国家基本药物制度建设。  相似文献   

8.
通过文献综述的方法分析了国外基本医疗卫生服务筹资模式,总结归纳出四点经验:加强政府卫生立法和政治承诺,重视政治、经济和文化因素对筹资模式的影响,拓宽筹资渠道、调整筹资结构和建立长效筹资机制,合理划分中央和地方卫生支出责任,旨在为进一步研究我国基本医疗卫生服务筹资机制的建设提供借鉴。  相似文献   

9.
社区基本药物制度的实践探索   总被引:1,自引:0,他引:1  
实施基本药物制度是解决当前医药购销领域诸多问题,规范医疗机构用药行为,降低医药费用负担的重要举措。潍坊市在普及基本医疗卫生制度实验性研究中,围绕基本药物制度原则和建立基本药物供应体系、筹资补偿机制、业务工作制度、经济管理制度等进行了创新,并率先在基层医疗机构进行了实践。文章重点对上述实践情况进行总结,对制度的实施效果进行分析评价。  相似文献   

10.
通过阐述太原市城镇居民基本医疗保险的筹资机制,结合文献研究,并且从医疗保险的筹资渠道、筹资标准的变化、筹资方式等方面提出完善太原市城镇居民基本医疗保险筹资机制的思考,以促进太原市城镇居民基本医疗保险筹资机制的健康发展。  相似文献   

11.
Laing R 《Africa health》1991,14(1):32-33
The essential drugs concept encompasses national drug policy, selection, quantification, quality assurance, procurement, inventory control and distribution, financing, rational drug use, and training. People from all sectors and levels were involved in developing Tanzania's national drug policy which was approved in 1991. The process developing a policy in Kenya continues. The policy will allow Kenya's Ministry of Health to implement various operational changes (e.g., improvements in hospital drug management). 40 sub-Saharan African (SSA) countries have a national essential drug list (EDL). A synergistic effect results when EDLs are merged with standard treatment guidelines (STGs) (e.g., in Tanzania and Zimbabwe) or constructed with STGs and a national formulary. The Federal Ministry of Health in Nigeria designated 209 drugs as essential drugs, while Nigerian states determined their own EDLs based on these 209 drugs. Spreadsheet models use morbidity patterns, past consumption, and population to help countries quantify drug needs which are then used to determine drug procurement. Various problems with quality assurance in regional and national quality control laboratories in SSA include staff turnover, limited equipment maintenance, and lack of reagents and laboratory standard solutions. A database, structured, flexible drug registration system allows countries (e.g., Zimbabwe) to monitor drug suppliers and agents. Drug procurement has improved in countries with established procurement systems. Computers help control and manage drug inventories. Kenya, Mozambique, Tanzania, and Uganda distribute ration kits of prepackaged drug selections. Cash and carry in Ghana, hospital fees in Kenya, and community insurance schemes in Guinea Bissau are some financing schemes in SSA. The International Network for the Rational Use of Drugs is operating in Ghana, Nigeria, the Sudan, and Tanzania. Training courses in drug supply management are held in Ghana, Tanzania, and Zimbabwe.  相似文献   

12.
目的:了解海南省市县际间基本医疗卫生服务均等化现状,为促进全省基本医疗卫生服务均等化建设提供参考。方法:利用海南省、我国及经合组织国家等卫生统计数据,对海南省市县际间基本医疗卫生服务均等化指标进行分析。结果:资源分布均等化方面,机构地理可及性相差较大,医护比为1∶1.2,资源分布的基尼系数大于0.3;筹资均等化方面,人均医疗保健支出低于全国,人均政府卫生支出额高的市县主要集中在各区域的中心,多数市县新农合住院实际补偿比在50%左右;服务提供均等化方面,多数市县床位使用率低于90%,药费占比在30%~40%,地区之间孕产妇及儿童健康管理差距较小,但管理率普遍低于全国。结论:基本医疗卫生服务资源分布与政治、经济等条件有关,筹资机制不健全、基本医疗和公共卫生服务提供能力低影响了基本医疗卫生服务的质量。建议合理布局基本医疗卫生服务资源,加大卫生筹资力度,提高基本医疗卫生服务提供能力。  相似文献   

13.
Perhaps no part of the health system is as imperiled by neoliberal economic reforms as the public drug sector. The national bill for pharmaceuticals can claim one-third of a developing country's annual health budget. This article describes the essential drugs program created by WHO in the 1980s to protect financially reduced ministries of health from the high prices charged by multinational pharmaceutical companies. It describes the backlash from the World Bank and UNICEF, which launched the Bamako Initiative and other community financing schemes and revolving drug plans in which individuals, families or community groups buy drugs above the wholesale purchase price; clinics use the proceeds to maintain drug supplies and subsidize other health services. When this plan failed, the Bank proposed outright privatization of drug purchase and supply, returning power to the multinational suppliers. The article ends with a consideration of patents and the new intellectual property rights as they pertain to pharmaceutical production in Africa.  相似文献   

14.
Pharmaceuticals are essential for preventive and therapeutic health services. Unfortunately, significant demand, limited funds and high prices contribute to frequent shortages of drugs in many public health programs. One method for financing pharmaceutical supplies has been the establishment of revolving drug funds (RDFs) in which, after an initial capital investment, drug supplies are replenished with monies collected from the sale of drugs. All too often however, the funds actually recovered are insufficient to replenish supplies and the fund is soon depleted. In this paper we consider the potential benefits and common pitfalls of revolving drug funds and then focus on the central role of financial planning in establishing drug sales programs. Experiences from a variety of countries suggest several causes for the failure of some RDFs, including: under-estimation of capitalization costs, prices set below true replacement cost, frequent failure to collect payment, delays in cash flow which make funds unavailable for replenishment of drug stocks, rapid program expansion for which additional capital funds are not available, losses due to theft and deterioration of drugs, unanticipated price increases due to inflation or changes in parity rates and foreign exchange purchase restrictions. Common to many of these problems is the lack of a businesslike orientation to RDFs and, in particular, lack of careful financial planning and management. Financial planning for an RDF includes four analytical tasks: assessment of the potential market, estimation of the costs of an RDF, establishment of the cost-recovery objectives, definition of the role of subsidies and surcharges.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

15.
16.
安徽省繁昌,铜陵两县门诊服务分析   总被引:3,自引:1,他引:2  
在为期6天的门诊病人调查中,共访问了2532人。92%的门诊病人是由于疾病来就诊。内科病人占一半,病种主要集中在呼吸系统与消化系统。用量最多的药品是抗感染药物与解热镇痛药,两者要占门诊用药的68.8%。平均每次门诊费用与药费分别为25.41元与14.52元,平均每次门诊用药数为2.03种,与国外报道及国内贫困县研究结果相比,都偏高。单因素与多因素分析都表示医疗保健制度对每次门诊费用有影响,公费医疗对门诊费用有负向作用,显示近期的公费医疗改革已初显成效。同时还表示医疗机构对每次门诊费用作用很大,在多因素分析中,与乡卫生院及村卫生室相比,县医院的偏回归系数最大。  相似文献   

17.
我国药品价格政策分析和改革思路探讨   总被引:1,自引:0,他引:1  
我国政府一直通过不同措施控制药品价格。目前政府对药品实行按社会平均成本,直接制定每一种药品的价格。这种定价机制的困难在于如何获得真实的企业生产成本信息。单纯通过降低药品价格控制药品费用增长,其作用是非常有限的。药品价格改革必须与医院补偿机制改革、社会医疗保险制度改革相协调。在改革药品定价机制时,可以考虑使用参考定价的方法,引入药物经济学的评价;加强对药品价格改革的研究和监督,评价药品价格改革对基本药物可及性的影响。  相似文献   

18.

Background

Sufficient and sustainable financing of the health system is essential for improving the health of the community. The health systems financing of the EMR countries is facing the challenge. Assessment and ranking of healthcare financing can help identify and resolve some challenges of health systems. So, the aim of this study is to evaluate and rank the condition of the health sector financing in the EMR countries.

Methods

This study was a cross-sectional study. The data was of secondary type, extracted from the official WHO and World Bank data. The six healthcare financing indicators in a 10-year interval (2005–2014) in 19 EMR countries analyzed using Grey Relation Analysis and Shannon Entropy.

Results

On average, the countries in the EMR region spent 4.87% of their GDP on the health sector. Jordan and Qatar allocated the highest (8.313) and the lowest (2.293) percentages of their GDP to the health sector, respectively. The results showed That Qatar was in a better condition than other EMR countries during 2005–2014 in terms of the health system financing and earned the first rank. After that, the UAE and Kuwait were ranked second and third.

Conclusions

There is a lot of inequality among the EMR countries in terms of health financing. However, our findings confirmed that only increasing the total health expenditure in a country would not improve its financing status compared to other countries, but it also depends on financing methods.
  相似文献   

19.
After giving a broad picture of the main characteristics ofthe Malian health system, and of this particular study, theauthors present the essential results obtained: trends in thehealth system financing, composition of the recurrent expendituresat the public health sector facilities, distribution of expendituresbetween districts, hospitals and national administrative boards,and distribution of recurrent and investment expenditures betweennational and foreign funding. They then examine more closelythe most important household expenditures on health services(traditional healing and medicines, drugs, private fees andhealth-related transport). A summary table of the main sourcesof funds for recurrent costs financing in the health sectoris presented for 1986. The paper concludes with a brief discussionof some proposals to solve the recurrent cost financing problemthat have recently been considered by the Ministry of Health.  相似文献   

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