认真推行药品焦点招标采购遏制医药购销中的不正之风

1999年以来，我市卫生系统按照国务院反腐倡廉纠风工作部署，结合我市医疗卫生单位的实际，认真开展了以推行药品集中招标采购制度为核心内容的纠正医药购销中不正之风工作。经过1年多的探索和实践，初步摸索和建立了一套切实可行的运行机制和管理制度，取得了较好的效果，目前，全市15所县级以上综合医院全部实行了药品集中招标采购制度，共招投标138次，涉及品种961个，金额达5116.91万元，与招标前相比，招标药品采购价格平均下降10.92%，零售价格平均下降13.65%，累计向群众让受678.19万元，通过实行这一制度，进一步强化了市场竞争机制，降低了药品购销成本，控制了药品虚高定价，有效地遏制了药品采购过程中的不正之风和腐败行为，保证了药品质量，药品收入占医院总收入比重明显降低，更趋合理，1999年，全市15家县以上综合医院药品收入占医院总收入的38.98%,较上年度平均下降4.8个百分点，2000年药品收入占总收入的比重继续回落，，每门诊人次平均收费68.7元，每床日平均收费125.9元，出院者平均医药费用828.3元，使患者医疗负担进一步减轻，为推动医疗卫生体制改革，建立城镇职工基本医疗保障制度奠定了基础。     

药品集中招标采购模式设计与应用

近年来 ,潍坊市坚持以深化卫生改革为突破口 ,采取综合配套措施 ,不断加大宏观调控力度 ,药品采购制度改革取得明显成效。我们选择数家医疗机构联合组织招标采购的模式 ,已连续组织开展了3次规模较大的药品集中招标采购 ,1725个抗微生物类药品纳入招标采购范围 ,已采购招标药品1500万元 ,让利患者314万元。一、主要做法(一 )制定总体工作目标。一是确定工作思路 ,坚持“内抓政策配套 ,外抓协调推动” ,运用医疗机构联合集中招标采购模式和统一采购多种形式 ,引入竞争机制 ,完善医院药品采购制度。目前已完成了规模较大的药品集中招标采购 ,…     

迁安：推进医疗药品器械采购见成效

近年来，河北省迁安市卫生局全力推进药品集中招标采购工作，自2000年至今，已集中招标采购药品及器械18次，总金额6393万元，节约资金767．16万元，总节支比例为12％。尤其是2004年，卫生局积极运作，增加招标品种，扩大集中招标采购范围，把新型农村合作医疗用药目录所列药品全部纳入公开招标采购，品种由开始的450种增加到现在的1181种。     

药品集中招标采购试点工作分析

按照药品集中招标采购的有关文件精神 ,自 2 0 0 1年以来全国各地陆续开展了药品集中招标采购试点 ,积累了一定的经验 ,同时也发现一些亟待解决的问题。根据上饶市药品集中招标采购情况 ,兹对药品集中招标采购试点工作分析如下 :1　基本情况2 0 0 1年 10月 ,江西省召开了全省药品招标采购工作会议 ,会议确定上饶、鹰潭两市为药品集中招标采购试点城市。按照省政府的要求 ,自 11月份开始 ,上饶市城区 7家医院在市政府的统一领导下 ,历经 4个月完成了首批 3大类、5 73个品种的药品集中招标采购工作。 12家中标企业和医院签订了 343个药品品种…     

我院实行药品集中公开招标采购的尝试

2000年7月,经国务院同意,卫生部等5部门联合颁布了《医疗机构药品集中招标采购试点工作若干规定》(以下简称《规定》),使全国药品集中招标采购工作普遍展开。我院是一所拥有600张床位的三级甲等医院,年药品采购金额2000余万元。从2000年下半年起,我们依据“规定”精神,参照军内外一些医疗单位的成功经验,综合了全国各地120余家医药经销单位的药品供应信息,对全院物资采用“集中管理,招标采购,全程监控”的形式,对包括药品在内的医院物资的管理进行了改革,率先在当地实行了药品公开招标和药品降价让利于患者,在医院内外引起了强烈的反响。实行公开招标采购后,供货单位由原来的100余家,减少为13家,     

药品集中招标采购实践与思考

2001年以来，为尽快改变药品采购过程中虚高定价、高额让利的不合理状况，遏制医疗费支出上涨势头，我们在本局卫生系统的5个医院、4个分院推行药品集中招标采购制度，先后进行了4次规模由小到大的药品集巾招标采购，到目前为止，招标药品品种达到697种，1062个品规，涵盖了临床常用药物的70％以上，预计年采购金额可达7100     

句容市实施药品集中招标采购的做法与体会

自2000年起，江苏省句容市卫生局推行药品集中招标采购，三年多来，集中招标采购总金额达9184万元，药品平均降价幅度达25％，实现了药品集中招标覆盖面、临床用药招标采购量、药品供应商进入招标采购中心、药品收支实行专户管理四个100％的目标，取得了群众、药品供应商、医疗机构三方满意的良好效果。     

医疗机构药品集中招标采购探索

根据《关于城镇医药卫生体制改革的指导意见》和卫生部等部门制定的《医疗机构药品集中招标采购试点工作若干规定》 ,在广泛调研 ,反复论证 ,并借鉴其他城市经验的基础上 ,宁波市积极开展了医疗机构药品集中招标采购工作的探索 ,基本形成一套科学、规范、行之有效的工作机制和操作方法。一、基本情况截止２００１年６月底 ,按目前国家规定零售价格计算 ,两次药品招标共推出的２２９只药品及其规格 ,占参加招标的１２家医疗机构同期销售的２５ %左右 ,累计向社会让利２４６万元。随着医疗机构药品集中招标采购的推广 ,我市参加药品招标的医疗…     

药品价格调整及集中招标采购对患者药品费用负担的影响

中国医科大学附属第一医院2002年7月－9月间药品实际销售金额为3780．4万元，按2001年6月1日时政策允许的最高零售价格计算可销售4167．2万元，药品实际销售金额降低了9．3％（386．8万元／6167．2万元），其中政府调价因素致药品零售总额下浮4．0％（1671万元／4167．2万元），统一招标采购因素致药品零售总额下浮4．3％（179．8万元／4167．2万元），其他因素致药品零售总额下浮0．95％（39．9万元／4167．2万元。这一结果证实了政府调价及集中招标采购政策的实施已在一定程度上减轻了社会的药品费用负担，但评估降低药品零售价格的措施对降低社会总药品费用的影响程度是一个复杂的过程，参与因素较多，单纯以某类或某品牌药品价格降低的幅度并不能准确反映社总药品费用减轻的程度。     

医疗机构药品集中招标采购试点工作若干规定

一、为规范医疗机构药品购销活动 ,提高药品采购透明度 ,遏制药品流通领域不正之风 ,减轻社会医药费用负担 ,保证城镇职工基本医疗保险制度顺利实施 ,依据国务院办公厅转发国务院体改办等部门《关于城镇医药卫生体制改革的指导意见》,按照《中华人民共和国招标投标法》,结合药品采购工作的特点 ,制定本规定。二、县及县以上医疗机构药品集中招标采购试点工作必须遵守本规定。三、医疗机构是药品招标采购的行为主体。具有编制招标文件和组织评标能力的医疗机构可自行组织或数家医疗机构联合组织招标采购 ,也可委托招标代理机构开展招标采购。…     

Acceptability of willingness to pay techniques to consumers

Objective The purpose of this study was to assess and compare the proportion of usable responses and protest votes obtained with two willingness to pay (WTP) techniques, contingent valuation (CV) and discrete choice experiment (DCE) and to assess the acceptability of the techniques to respondents. Setting and participants Pregnant women attending the public antenatal clinics of a Sydney teaching hospital were surveyed. Main variables studied Preference for either Treatment A (artificial rupture of the membranes followed by intravenous oxytocin) or Treatment B (prostaglandin E₂ gel followed by oxytocin if necessary) was assessed. Then WTP for the preferred treatments was assessed using CV and WTP for specific attributes of the treatments in the DCE. In addition, the acceptability of the two techniques was compared in terms of responses deemed to be valid according to defined criteria, protest votes and comments recorded by consumers. Results With the CV, 74% of respondents chose gel and their maximum WTP was Aus$178 compared with $133 for the alternative. A total of 68% of responses were deemed to be valid including 5% who may have been expressing a protest vote. With the DCE, respondents were WTP $55 for every 1 h reduction in the length of time from induction to delivery. A total of 72% of responses were deemed valid and only two of these 258 women were considered to have expressed a protest vote. Conclusions Only a small number of women expressed objections to the use of WTP questions in health‐care and the majority of women completed both questions successfully.     

重视主要诊断的选择适应医保制度改革

目的了解在主要诊断选择中存在的问题及其对单病种费用的影响.方法首先依据病案内容判断主要诊断的正确性,然后进行医疗质量及单病种费用的统计和分析.结果在主要诊断的选择中存在着概念不清、人为拔高、错选它科疾病、诊断依据不充分及诊断名称不规范等问题.结论主要诊断选择不当可致医疗质量统计和病种费用统计失真,这将影响医院管理者或卫生管理部门的决策,也影响着病案资源的利用和共享.     

Factors influencing the conversion of carotenoids to retinol: bioavailability to bioconversion to bioefficacy

Vitamin A (retinol) is a necessary nutrient for vision, reproduction, growth, and immune function. Pro-vitamin A carotenoids are an important source, especially in developing countries. While preformed vitamin A is readily available from foods, carotenoids are much more difficult to assimilate. A number of factors have been identified that either enhance or hinder the bioavailability of carotenoids. These have been presented in the literature and given the mnemonic SLAMENGHI by some researchers. The following factors are summarized: Species of carotenoid, molecular Linkage, Amount in the meal, Matrix Properties, Effectors, Nutrient status, Genetics, Host specificity, and Interactions between factors. Identifying which of these are key issues for the general public, and promoting the increased consumption of fruits and vegetables with moderate and high levels of pro-vitamin A carotenoids, are important to vitamin A status and overall good health.     

Characteristics of men most likely to respond to an invitation to be screened.

Some of the characteristics of men, with known risk factors, who were most likely to respond to an invitation to be screened in a national randomized clinical trial to prevent heart disease were determined in 18,872 men, 35-57 years of age, members of the Kaiser Foundation Health Plan of Oregon. Demographic characteristics and risk factor variables (blood pressure, blood cholesterol, and cigarette smoking levels) were abstracted from medical records. The men were ranked high priority or low priority according to level of risk. All age-eligible men in the health plan received at least one invitation to be screened, with high-priority men receiving more invitations. Despite concentrated efforts to bring them in, less than one-half the high-priority men were screened. Participants were older and wealthier than non-participants, and more likely to have more dependents and to routinely use medical services. Whether or not a man received a medical care service within the preceding two years was a powerful discriminating variable in both the univariate and multivariate analyses reported. The findings suggest that health care programs serving a stable population group should give more consideration to screening in routine medical care.