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基于多准则决策分析的县域医共体药品目录遴选体系构建与实证
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| 篇名： | 基于多准则决策分析的县域医共体药品目录遴选体系构建与实证 |
| TITLE： | Construction and empirical study of selection system for drug directory of county-level medical community based on multi-criteria decision analysis |
| 摘要： | 目的 探索构建基于多准则决策分析的县域医共体药品目录遴选体系，为医共体药品目录的遴选提供决策依据。方法以重庆市某县域医共体为例，采用德尔菲法和层次分析法构建县域医共体药品目录遴选体系；按照所构建的指标体系对待遴选药品进行量化评分，再依据药品综合评分遴选药品目录；在该目录实施1年后通过问卷调查评估目录的实施效果。结果两轮德尔菲法专家咨询的专家权威系数均大于0.8，Kendall’sW分别为0.213和0.196（P均小于0.001）。最终确定的药品目录遴选体系包括安全性、有效性、经济性、可及性、创新性5个评价维度，共8个评价指标。按上述方法遴选的药品目录中，集采药品、医保药品、基本药物数目占比均较遴选前有所升高；化学药品的综合评分为50.25～96.31分，70～100分的药品占比由遴选前的78.06%上升为85.82%，其中抗虫药的综合评分最高，消化道及代谢类药数量最多；遴选后药品目录中药品的各指标评分和综合评分均较遴选前显著升高（P＜0.05）。结论本研究构建的县域医共体药品目录遴选体系科学客观、可操作性强，有利于促进医共体药品的规范化统一管理。 |
| ABSTRACT： | OBJECTIVE To explore the construction of selection system for drug directory of the county-level medical community based on multi-criteria decision analysis， and provide decision-making basis for the selection of drug directory of medical community. METHODS Taking county-level medical community in Chongqing as an example，Delphi method and analytic hierarchy process were employed to construct the selection system for drug directory of the county-level medical community. Selected drugs were quantitatively scored based on the constructed index system， and the drug directory was selected according to the drug’s comprehensive score. The implementation effect of the directory was then evaluated through questionnaire surveys one year after the implementation of the directory. RESULTS The expert authority coefficients of the two rounds of consultation were＞ 0.8， with Kendall’s W values of 0.213 and 0.196， respectively （P＜0.001）. Finally， the selection system for drug directory of the medical community was determined to include five evaluation dimensions： safety， effectiveness， economy， accessibility， and innovation， along with eight evaluation indicators. In the drug directory selected according to the above method， the proportions of centrally procured drugs， medical insurance drugs， and essential drugs had all increased compared to before the selection； the comprehensive scores of chemical drugs ranged from 50.25 to 96.31 scores， and the proportion of drugs scoring between 70 and 100 scores had increased from 78.06% before selection to 85.82%. Among them， antiparasitic drugs had the highest comprehensive scores， while drugs for the digestive tract and metabolism were the most numerous. The evaluation scores of each indicator and the comprehensive scores of drugs in the drug directory after the selection process increased significantly than before selection （P＜ 0.05）. CONCLUSIONS The selection system for drug directory of the county-level medical community constructed in this study is scientific， objective and operable. This process facilitates the promotion of standardized and unified management of drugs in the medical community. |
| 期刊： | 2025年第36卷第08期 |
| 作者： | 郭艺楠；俞秀恒；谢雨晴；向世欣；林欢；龙友琦；赵语 |
| AUTHORS： | GUO Yinan，YU Xiuheng，XIE Yuqing，XIANG Shixin，LIN Huan，LONG Youqi，ZHAO Yu |
| 关键字： | 县域医共体；药品目录；药品遴选；多准则决策分析；评价指标体系；循证证据 |
| KEYWORDS： | county-level medical community； drug directory； drug selection； multi-criteria decision analysis； evaluation index |
| 阅读数： | 12 次 |
| 本月下载数： | 1 次 |
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