重庆市基层医疗卫生机构实施国家基本药物制度的实践与思考

目的:研究基层医疗卫生机构实施国家基本药物制度的实践成效。方法:采用文献资料研究和专家访谈法。结果:重庆市实施国家基本药物制度的实践中存在不少问题,例如基本药物品种构成不合理,遴选专家选拔原则不清晰;配送效率受采购点击率影响;服务人口测算方法不合理、基层人员工作积极性不高;国家基本药物制度与基本医疗保险制度衔接有待加强。结论:应动态管理基本药物目录、建立科学原则选拔专家;集中招标采购遵循市场原则;合理测算服务人口、充分发挥激励机制;加强监督,加快医疗、医药、"医保"同步衔接。

Practice and Thinking about National Essential Drug System of Primary Medical Institution in Chongqing

OBJECTIVE：To study the effects of the implementation of national essential drug system in primary medical institutions in Chongqing.METHODS：Literature study and qualitative research were conducted.RESULTS：There were among problems in the implementation of essential drug system in primary medical institutions in Chongqing,such as species composition of essential drugs was unreasonable;the principle for the selection of experts was not clear;distribution efficiency was affected by purchase click-trough ratio;uniform bidding and distribution was more expensive than independent purchase;service population estimation method was unreasonable,and the motivation of staff was not high at primary level;the connection of essential drug system with basic medical insurance system should be strengthened.CONCLUSIONS：It is suggested to management essential drug list dynamically and establish the selection principle of scientific experts;centralized bidding and purchasing to follow market principles;estimate service population reasonably and give full play to incentives;strengthen supervision and speed up synchronous connection of medical care,medicine and insurance.