河南省药品批发企业新版GSP跟踪检查缺陷项目分析

目的：分析河南省药品批发企业实施新版《药品经营质量管理规范》（GSP）后跟踪检查中发现的共性问题,为今后制定有针对性的监管措施和企业避免出现类似问题提供参考。方法：对224家药品批发企业实施新版《药品经营质量管理规范》后跟踪检查中发现的缺陷项目进行统计,分析药品批发企业GSP质量体系存在的主要问题和原因,提出相应的解决措施。结果与结论：河南省药品批发企业在药品储存与养护、设施与设备、收货与验收、采购、人员与培训等方面还存在不足,企业应当持续不断地改进和完善质量管理体系;提高培训的针对性和实效性。     

The effect of cool water pack preparation on vaccine vial temperatures in refrigerators

Cool water packs are a useful alternative to ice packs for preventing unintentional freezing of vaccines during outreach in some situations. Current guidelines recommend the use of a separate refrigerator for cooling water packs from ambient temperatures to prevent possible heat degradation of adjacent vaccine vials. To investigate whether this additional equipment is necessary, we measured the temperatures that vaccine vials were exposed to when warm water packs were placed next to vials in a refrigerator. We then calculated the effect of repeated vial exposure to those temperatures on vaccine vial monitor status to estimate the impact to the vaccine. Vials were tested in a variety of configurations, varying the number and locations of vials and water packs in the refrigerator. The calculated average percentage life lost during a month of repeated warming ranged from 20.0% to 30.3% for a category 2 (least stable) vaccine vial monitor and from 3.8% to 6.0% for a category 7 (moderate stability) vaccine vial monitor, compared to 17.0% for category 2 vaccine vial monitors and 3.1% for category 7 vaccine vial monitors at a constant 5 °C. The number of vials, number of water packs, and locations of each impacted vial warming and therefore percentage life lost, but the vaccine vial monitor category had a higher impact on the average percentage life lost than any of the other parameters. The results suggest that damage to vaccines from repeated warming over the course of a month is not certain and that cooling water packs in a refrigerator where vaccines are being stored may be a useful practice if safe procedures are established.     

保障常用低价药品供应:基于治理工具角度的分析

有效保障常用低价药品的供应,对于保障公众健康、维护社会公平以及顺利推进新医改都具有非常重要的意义。本文从公共治理理论中的治理工具分析角度出发,重点分析如何结合和优化多样化的政策工具的使用来综合确定常用低价药品的工具,即应用＂志愿—强制—混合＂治理工具分析框架,从志愿性（家庭与社区、志愿者、市场）、强制性（政府命令—控制型监管、成立公共企业、直接提供）和混合性治理工具（信息披露与规劝、补贴、产权拍卖、税收与使用者付费）等多个角度对保障常用低价药品的供给提出对策,最后提出了巧用价格杠杆、完善采购办法、建设药价信息披露机制以及确立政府补贴与产业政策战略四方面的具体政策建议,以此完善最近出台的相关最新政策内容,从而确立我国保障常用低价药品供应的总体战略。     

供应驱动角度的双向转诊协同体系构建

双向转诊是有效配置区域上下级医疗机构间的医疗服务资源,构建合理分层就诊体系的重要举措.从供应驱动角度分析了双向转诊协同概念,指出了存在问题,提出了构建方法：完善供应链体系;协调供需平衡;信息实时共享;政策引导支持;与需求驱动互补等.     

多种形式中心供应室工作模式的探讨

作者简述了目前中小型供应室的发展困境,并提出了以共享医疗资源、提高工作质量为目的的三种代消毒模式:辅助大型医疗机构完善自身消毒供应中心已承担周边小型医疗机构的代消毒工作,建立区域性的中心供应室、引入社会专业代消毒机构。     

Uruguayan Cannabis Social Clubs: From activism to dispensaries?

BackgroundIn 2013 Uruguay regulated three models for the supply of cannabis for recreational use (Law 19.172), including Cannabis Social Clubs (CSCs). According to the Cannabis Regulation and Control Institute, 110 CSCs are active at the time of writing.ObjectivesThis paper has a twofold goal. Firstly, it aims to take stock of how the CSC model has continued to be implemented in practice, drawing on the first-hand accounts of those involved in its management. Secondly, our analysis seeks to contribute to the understanding of the CSC model by considering the different variants of the model that have emerged in Uruguay.MethodologyOur analysis draws on qualitative research conducted in Uruguay between June and October of 2018. We conducted 15 semi-structured and face-to-face interviews with representatives of registered Uruguayan CSCs and with 13 other stakeholders.Results/conclusionsCSCs’ role as cannabis suppliers is perceived positively in terms of the type of cannabis produced and the means of distribution. We found that truly social CSCs co-exist with, and may be losing ground to, quasi-dispensary clubs. A number of factors may have contributed to this, including the Uruguayan regulatory framework, institutional context, and disengagement of members and/or CSC managers. This raises potential new challenges as to the contribution of the CSC model from a harm reduction perspective.     

The benefits of redesigning Benin's vaccine supply chain

Introduction

New vaccine introductions have put strains on vaccine supply chains around the world. While increasing storage and transportation may be the most straightforward options, it is also important to consider what financial and operational benefits can be incurred. In 2012, suboptimal vaccine coverage and impending vaccine introductions prompted the Republic of Benin's Ministry of Health (MOH) to explore ways to improve their vaccine supply chain.

Methods

Working alongside the Beninese MOH, we utilized our computational model, HERMES, to explore the impact on cost and vaccine availability of three possible options: (1) consolidating the Commune level to a Health Zone level, (2) removing the Commune level completely, and (3) removing the Commune level and expanding to 12 Department Stores. We also analyzed the impact of adding shipping loops during delivery.

Results

At baseline, new vaccine introductions without any changes to the current system increased the logistics cost per dose ($0.23 to $0.26) and dropped the vaccine availability to 71%. While implementing the Commune level removal scenario had the same capital costs as implementing the Health Zone scenario, the Health Zone scenario had lower operating costs. This increased to an overall cost savings of $504,255 when implementing shipping loops.

Discussion

The best redesign option proved to be the synergistic approach of converting to the Health Zone design and using shipping loops (serving ten Health Posts/loop). While a transition to either redesign or only adding shipping loops was beneficial, implementing a redesign option and shipping loops can yield both lower capital expenditures and operating costs.     

新型冠状病毒肺炎患者复用医疗物品的处理方法与效果

在新型冠状病毒肺炎疫情期间,我院确定为定点救治医院,消毒供应中心作为医院无菌物品物资保障供应部门,根据病毒特点和国家发布的各项相关文件和指南,针对疫情当前存在的问题及时制订了各项应对措施:确定消毒供应中心隔离要求和各区人员防护措施,落实人力资源优化和人员培训,修订被新型冠状病毒污染的复用医疗物品消毒预处理、回收和清洗消毒流程,并通过实践确保方法正确,符合院感要求,为患者和医护人员提供了合格的无菌物品供应。