儿科医联体中基层医疗机构的儿童药品短缺问题分析与改进措施

目的：本调研旨在分析基层医疗卫生机构儿童药品短缺的现状和原因，并提出具有针对性的改进措施与建议。方法：通过收集2020年1~12月南京医科大学附属儿童医院所在的儿科医联体内各基层医疗卫生机构逐月上报的药品短缺信息，梳理短缺药品特点，分析用药短缺发生的影响因素。结果：基层医疗卫生机构儿童短缺药品分布在各个治疗领域，其中上报药品短缺信息121条，涉及药物品规42种，且与某类疾病关联不大。短缺原因主要为药品交易价格低，企业不愿意生产。结论：解决儿童药品短缺问题，建议依托儿科医联体上下联动、资源共享优势；采取药品采购目录衔接；建立药品短缺管理标准化决策程序；并呼吁政策层面制定有关措施，保证儿童药品供应链的连贯通畅。

Research on Monitoring and Early Warning of Pediatric Drug Shortage Based on Pediatric Medical Confederation Platform

Objectives: The purpose of this study aims to analyze current situation and causes of medicine shortage in primary medical and health institutions, and propose targeted improvement measures and suggestions. Methods: We collected the information of drug shortage reported by the primary medical and health institutions in the Pediatric Medical Association of Nanjing Medical University Children''s Hospital from January to December 2020, sorted out the characteristics of the shortage of drugs, and analyzed the influencing factors of the occurrence of drug shortages. Results: The shortage of medicines for children in primary medical and health institutions distributed in various treatment fields. There were 121 reports of medicine shortages, involving 12 categories, without significant relation to a certain type of disease. The main reason for the shortage was that the transaction prices of medicines were low and enterprises were unwilling to produce. Conclusions: Drug shortages still occur in primary medical and health service institutions. It is recommended that the primary medical and health service institutions should rely on the Pediatric Medical Association to adopt drug procurement catalogue linkages, establish standardized decision-making procedures for drug shortage management; and the state should take relevant measures to ensure the continuity of the supply chain of children''s medicines.