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国家医保谈判药品在浙江省三级医疗机构的落地实践
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| 篇名： | 国家医保谈判药品在浙江省三级医疗机构的落地实践 |
| TITLE： | Landing practices of national medical insurance negotiated drugs in tertiary medical institutions of Zhejiang province |
| 摘要： | 目的 为我国国家医保谈判药品（简称“国谈药品”）在省级层面的落地提供参考和借鉴。方法通过查阅2021年1月－2022年3月国家医保局、浙江省医保局等官方网站公开发布的数据，结合政策文件，对浙江省各地市三级医疗机构数量、国谈药品实际配备情况、国谈药品可获得率、国谈药品品种配备率、医疗机构配备率等进行描述性分析；采用Spearman秩相关检验对浙江省三级医疗机构配备的国谈药品品种数与浙江省各地市人均可支配收入、配备国谈药品的三级医疗机构数、疾病诊断相关分组（DRG）实施时长等进行相关性分析。结果截至2022年第1季度，浙江省135家三级医疗机构共配备国谈药品261种，占2021版国谈药品目录（275种）的94.91%；醋酸戈舍瑞林缓释植入剂、沙库巴曲缬沙坦钠片、注射用阿替普酶等品种配备率较高，配备的国谈药品种类与浙江省城乡居民排名前10位的疾病死亡原因高度重合。杭州市的三级医疗机构配备种类最多，达230种，衢州市最低，仅为34种；舟山市的医疗机构配备率最高（100%），丽水市最低（57.14%）。国谈药品配备品种数与各地市人均可支配收入、配备国谈药品的三级医疗机构数量均呈正相关（P＜0.01），与DRG的实施时长无明显相关性（P＞0.05）。结论浙江省国谈药品的落地情况总体较好，国谈药品三级医疗机构配备率、药品品种配备率较高。建议国谈药品的省级落地需多方联动，政策制定部门应“松绑“”驱动”双管齐下，畅通药品进院链条；医保部门应完善“双通道”管理机制，分担医疗机构用药压力；同时，还应完善多层次医疗保障体系，提高国谈药品医保报销水平。 |
| ABSTRACT： | OBJECTIVE To provide reference for the subsequent landing of national medical insurance negotiated drugs （referred to as “national negotiated drugs”） at the provincial level. METHODS By reviewing the data publicly released by the official websites of National Healthcare Security Administration and the Healthcare Security Administration of Zhejiang Province， combined with policy documents， the descriptive analysis was conducted on the number of tertiary medical institutions， the actual allocation of national negotiated drugs， the availability rate of national negotiated drugs， the allocation rate of national negotiated drug varieties， and the allocation rate of medical institutions of various cities in Zhejiang province. The Spearman rank correlation test was used to analyze the correlation between the number of types of national negotiated drugs equipped in tertiary medical institutions in Zhejiang province and the per capita disposable income， the number of tertiary medical institutions equipped with national negotiated drugs， and the implementation time of disease diagnosis-related grouping （DRG） of various cities in Zhejiang province. RESULTS As of the first quarter of 2022， 135 tertiary medical institutions in Zhejiang province were equipped with a total of 261 types of national negotiated drugs， accounting for 94.91% of the 2021 edition of the National Negotiated Drugs Catalogue （275 types）. The allocation rates of Goserelin acetate sustained-release implant， Sacubitril valsartan sodium tablets， Alteplase for injection and other varieties were at high level， and the types of national negotiated drugs equipped were highly coincident with the top 10 causes of death with disease of urban and rural residents in Zhejiang province. The tertiary medical institutions in Hangzhou had the most types of national negotiated drugs， with 230 types， while Quzhou had the lowest， with only 34 types； allocation rate of national negotiated drugs in medical institutions of Zhoushan was the highest （100%）， while that of Lishui was the lowest （57.14%）. The types of national negotiated drugs equipped were positively correlated with per capita disposable income in various cities and the number of tertiary medical institutions equipped with national negotiated drugs （P＜0.01）， and there was no significant correlation with the length of implementation of DRG （P＞0.05）. CONCLUSIONS mail：lanyao@mails.tjmu.edu.cn The landing of national negotiated drugs in Zhejiang province is generally good， with a high rate of equipping tertiary medical institutions with national negotiated drugs and a high rate of equipping drug varieties. Therefore， it is recommended that the provincial implementation of national negotiated drugs should be multi-faceted， and policy-making departments should adopt a dual-channel of “unbundling” and “driving” to smooth the drug chain into hospitals. The health insurance sector should improve the “dual channel” management mechanism to share the pressure on hospitals to use drugs. At the same time， it should also improve the multi-level medical security system and raise the level of reimbursement of medical insurance for national negotiated drugs. |
| 期刊： | 2023年第34卷第10期 |
| 作者： | 彭瑾；蒋俊男；邱增辉；刘兰芳；姚岚 |
| AUTHORS： | PENG Jin，JIANG Junnan，QIU Zenghui，LIU Lanfang，YAO Lan |
| 关键字： | 国家医保谈判药品；落地实践；双通道；浙江；疾病诊断相关分组 |
| KEYWORDS： | national medical insurance negotiated drugs； landing practice； dual-channel； Zhejiang； DRG |
| 阅读数： | 190 次 |
| 本月下载数： | 5 次 |
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