以灯塔市为例探讨县级药品零售市场监管策略

目的： 为规范药品零售市场的经营秩序，促进县级药品零售市场健康有序的发展，确保百姓用药安全提供参考。方法： 通过专家访谈、文献检索等方法对以灯塔市为例的县级药品零售市场的监管政策、现状、存在问题及其形成原因进行系统分析，研究县级药品监管部门对药品零售市场的监管对策。结果与结论： 造成县级药品零售市场监管不力的原因是多种多样的，既有国家相关法律法规的不健全，又有本地区域多种因素。灯塔市药品零售市场监管人员严重不足，同时药品零售企业开办条件较低，缺少相应的退出机制及鼓励政策，传统的监管手段具有滞后性。应加大基层监管力量，壮大基层执法人员队伍；同时政府应提高药品零售市场的准入门槛，完善药品零售市场的退出机制，出台鼓励连锁经营的政策，并采用电子监控的方式对药品零售企业开展有效的监督管理工作。     

社会药店药品经营质量管理规范认证检查中存在的问题分析及对策

目的 分析社会药店药品经营质量管理规范认证检查中发现的缺陷问题,探讨进一步改善对社会药店监管的措施及对策。 方法 对65家社会药店药品经营质量管理规范认证现场检查报告中出现的缺陷项目进行统计,分析存在的主要问题。 结果 共发现缺陷项396项次,其中主要缺陷项目168项次,一般缺陷项目228项次,平均每家6.1条缺陷项。缺陷项目频率较高的主要集中在人员管理、文件、采购与验收方面。 结论 贯彻实施药品经营质量管理规范,深化药品零售监管,应强化宣传教育和培训,加强监管队伍建设,建立信用监管机制,提高舆论监督作用。     

医保定点药店布局规划效果评价方法*

目的拟研制一种新的评价医保定点药店布局规划效果的方法,为政府在充分使用医保资金、合理定点医保定点药店上提供决策支持。方法为清晰表达规划地域内医保药店的有序竞争情况及局部区域的药品供给公平程度,研究借助地理信息系统软件作为辅助工具,以公平和效率为导向,有针对性地对医保定点药店布局规划的效果评价方法进行研制,并以某市为例探讨方法学的信度和效度。结果形成了两种评价医保定点药店布局规划效果的方法学,包括直接计算法和统计网格数量法,明确了其在地理信息系统中的命令和程序,并有效实现了规划效果的可视化表达。结论本研究研制的效果评价方法所得的可视化结果清晰直观、精细易懂,有助于决策者在决策中减少盲目性,快速决断,保证规划切实有效的落实,达到了规划目的。     

基本医疗保险定点零售药店的配置公平性分析——以深圳市为例

目的:探究深圳市医保定点零售药店的公平性及分布特征的变化,为进一步优化医保零售药店资源配置的公平性提供思路。方法:运用基尼系数、洛伦兹曲线和集聚度等方法衡量深圳市医保零售药店的公平性,再通过地理信息系统(Geographic Information System, GIS)技术将其布局可视化,分析其空间差异。结果:深圳市医保定点零售药店数量均呈现增长的趋势,基尼系数显示公平性也有所优化,但按地理面积分布的集聚度在深圳市各区之间差异较大。最近邻指数均小于1,医保定点零售药店分布模式属典型的聚集模式。医保定点零售药店从"南多北少"到逐渐呈现多中心发展的空间格局。结论:深圳市医保零售药店集聚水平存在区域差异,应以需要和需求相结合为依据优化医保定点零售药店的配置。     

Association between density and proximity of tobacco retail outlets with smoking: A systematic review of youth studies

BackgroundReducing the retail availability of tobacco has been proposed as a component of tobacco endgame, yet it is not known whether retail availability has a direct impact on smoking behaviours. A narrative review and a meta-analysis have been undertaken to examine the density and proximity of tobacco retail outlets, but were limited in scope, exposure and outcome variables. The aim of this current study was to undertake a systematic review of the international literature on the density and proximity of tobacco retail outlets to homes, schools and communities and their association with smoking behaviours among youth.MethodsWe reviewed and critically appraised the evidence documenting the association between density or proximity of tobacco retail outlets and smoking behaviours among school-age youth (18 and under), between 1 January 1990 and 21 October 2019. We reviewed original quantitative research that examined the associations of tobacco retail outlet density and proximity with individual smoking status or population-level smoking prevalence; initiation of smoking; frequency of tobacco use; sales to minors; purchasing by minors; susceptibility to smoking among non-smokers; perceived prevalence of smoking, and quitting behaviours.FindingsThirty-five peer-reviewed papers met the inclusion criteria. This review provided evidence of a relationship between density of tobacco retail outlets and smoking behaviours, particularly for the density near youths’ home. A study using activity spaces also found a significant positive association between exposure to tobacco retail outlets and daily tobacco use. The review did not provide evidence of an association between the proximity of tobacco retail outlets to homes or schools and smoking behaviours among youth.ConclusionsThe existing evidence supports a positive association between tobacco retail outlet density and smoking behaviours among youth, particularly for the density near youths’ home. This review provides evidence for the development and implementation of policies to reduce the density of tobacco retail outlets to reduce smoking prevalence among youth.     

Chicken as reservoir for extraintestinal pathogenic Escherichia coli in humans, Canada

We previously described how retail meat, particularly chicken, might be a reservoir for extraintestinal pathogenic Escherichia coli (ExPEC) causing urinary tract infections (UTIs) in humans. To rule out retail beef and pork as potential reservoirs, we tested 320 additional E. coli isolates from these meats. Isolates from beef and pork were significantly less likely than those from chicken to be genetically related to isolates from humans with UTIs. We then tested whether the reservoir for ExPEC in humans could be food animals themselves by comparing geographically and temporally matched E. coli isolates from 475 humans with UTIs and from cecal contents of 349 slaughtered animals. We found genetic similarities between E. coli from animals in abattoirs, principally chickens, and ExPEC causing UTIs in humans. ExPEC transmission from food animals could be responsible for human infections, and chickens are the most probable reservoir.     

北京部分市售整鸡中沙门菌和弯曲菌协同定量污染研究

目的对2013年北京部分市售整鸡样品中沙门菌和弯曲菌的定量污染水平、沙门菌血清型和弯曲菌种水平分布进行研究。方法 2013年5—7月采集北京市售整鸡样品33份,进行样品中沙门菌和弯曲菌的定量检测,并分别对沙门菌和弯曲菌进行血清分型和种水平鉴定。结果 19个样品检出沙门菌,检出率为57.6%;5个样品检出弯曲菌,检出率为15.2%;阳性样品中沙门菌和弯曲菌平均污染水平分别为119.4 MPN/100g和58.6 CFU/g。分离出的166株沙门菌被鉴定为14种血清型,最常见的为肠炎沙门菌,其次为印第安纳沙门菌。从同一样品中分离到共11种2个以上不同血清型组合的沙门菌,最常见的血清型组合为肠炎-印第安纳沙门菌。结论 2013年5—7月北京部分市售整鸡中沙门菌污染率较高、污染水平严重、血清型复杂。     

Concentration and drug prices in the retail market for malaria treatment in rural Tanzania

The impact of market concentration has been little studied in markets for ambulatory care in the developing world, where the retail sector often accounts for a high proportion of treatments. This study begins to address this gap through an analysis of the consumer market for malaria treatment in rural areas of three districts in Tanzania. We developed methods for investigating market definition, sales volumes and concentration, and used these to explore the relationship between antimalarial retail prices and competition. The market was strongly geographically segmented and highly concentrated in terms of antimalarial sales. Antimalarial prices were positively associated with market concentration. High antimalarial prices were likely to be an important factor in the low proportion of care‐seekers obtaining appropriate treatment. Retail sector distribution of subsidised antimalarials has been proposed to increase the coverage of effective treatment, but this analysis indicates that local market power may prevent such subsidies from being passed on to rural customers. Policymakers should consider the potential to maintain lower retail prices by decreasing concentration among antimalarial providers and recommending retail price levels. Copyright © 2009 John Wiley & Sons, Ltd.     

广州市药品零售市场发展状况调查

目的:为广州市药品零售市场的健康发展提供参考。方法:采用问卷方式对广州市单体和连锁药店进行市场调查,内容包括药店数量、药店连锁率、药店经营规模、药店年销售金额、药学人员整体素质等方面,并对143份有效问卷(共发放173份)进行统计分析,找出存在问题并提出建议。结果与结论:截至2010年3月,广州市的药店总数为6021家,总体连锁率为37.6%;2009年整体销售规模约为40亿元,连锁企业最高年销售额2～3亿元,市场份额无超过10%者;执业药师配备严重不足,整体素质不高。建议零售药店应向大型化、规模化、连锁化的方向发展,并促进非处方药的消费,加强药学人员培训,采取差异化经营。