我国基本医疗保险定点零售药店改革政策的量化分析
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篇名: 我国基本医疗保险定点零售药店改革政策的量化分析
TITLE: Quantitative analysis for reform policies of basic medical insurance designated retail pharmacies in China
摘要: 目的 梳理我国基本医疗保险定点零售药店(简称“定点零售药店”)改革政策,为门诊共济背景下该政策的完善提供参考。方法收集1998年12月至2023年6月来自国务院部委及其直属机构颁布的定点零售药店政策文本,采用内容分析法与社会网络分析法,构建基于政策主体、政策工具与政策过程的三维分析框架,对定点零售药店改革政策进行量化分析。结果与结论定点零售药店改革政策可大致分为萌芽起步、探索发展以及深化推进3个阶段。政策工具的使用以环境型工具为主,政策主体合作网络呈现“头-身-尾”链式结构。随着政策改革的推进,政策主体数量呈先下降后增长的趋势,政策发文数量呈现上升趋势,更强调药师体系建设、处方流转、医保支付以及“双通道“”门诊统筹”管理等工具的使用。建议在政策制定上,各政策主体应坚持顶层设计,重视不同发展阶段的特点,因地、因时调整政策工具的使用;并应加强部门间的合作交流,提高政策制定效率,实现政策协同,不断完善定点零售药店政策。
ABSTRACT: OBJECTIVE To sort out reform policy for basic medical insurance designated retail pharmacy (referred to as designated retail pharmacy) in China, and to provide reference for the improvement of the policy under the new situation of mutual- aid mechanism for covering outpatient bills. METHODS The policy texts on designated retail pharmacies issued by ministries and commissions of the State Council and departments directly under the State Council were collected from December 1998 to June 2023. The content analysis and social network analysis were adopted to construct a three-dimensional analytical framework based on the policy subject, the policy tool, and the policy process, in order to quantitatively analyze the policies on reforming designated retail pharmacies. RESULTS & CONCLUSIONS The reform policy of designated retail pharmacies can be roughly divided into three stages: germination, exploration and development, and in-depth promotion. The use of policy tools is dominated by environment-oriented tools, and the cooperation network of policy subjects presents a “head-body-tail” chain structure. With the advancement of policy reforms, the number of policy subjects showed a trend of decline followed by growth, the number of policy documents showed an upward trend, emphasizing the use of tools such as the construction of the pharmacist system, the flow of prescriptions, the payment of medical insurance, and the management of “dual-channels” and “outpatient co-ordination”. It is suggested that in terms of policy formulation, all policy subjects should adhere to top-level design, grasp the characteristics of the stage of policy development, and adjust the use of policy tools according to local and timely conditions; we should also strengthen cooperation and communication, improve policy formulation efficiency, achieve policy coordination, and continuously improve policies for designated retail pharmacies.
期刊: 2024年第35卷第06期
作者: 许洪皓;刘若颖;那昕;谢荣柏;褚淑贞
AUTHORS: XU Honghao,LIU Ruoying,NA Xin,XIE Rongbai,CHU Shuzhen
关键字: 定点零售药店;政策主体;政策工具;政策过程;量化分析
KEYWORDS: designated retail pharmacy; policy subjects; policy tools; policy processes; quantitative analysis
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