| Background:People's livelihood is one of the most concerned issues of the Chinese government in the process of building a well-off society. As everybody knowns, drug safety problem is closely related to people's livelihood.Effective supervision of drugs has a great bearing on ensuring the safe use of pharmaceuticals by consumers and on safeguarding the right to life and health of the general public. The Chinese government has always attached great importance to supervision over drug safety, and has always been committed to the goal of strengthening such supervision and guaranteeing public drug safety. For this purpose, it has gradually established the drug supervision network and continuously improved the drug supply network.Drug supervision network construction is construction of the county (area), countryside (town) and the village of three regulatory networks. The county-level supervision mainly include establishment of drug safety leading group. Drug supervision stations were established in the countryside and drugs information officer was set up in village. In addition, it has established a network for drug supply, fully satisfying the public's needs for drugs. In Hunan Province, the supply of drug is still great difference between urban and rural area. In cities, it is a problem that it is too expensive to see a doctor. However, in rural, it is the main problem that it is not only too expensive to see a doctor but also too difficulty to buy medicine. The result is that there are a lot of fake medicine in rural area. Therefore, the key of construction of drug supervision network and drug supply network is mainly in rural. In the vast rural areas, it is important to steadily enhance the guarantee level for the quality of drugs and the supply for drugs, due to the constant improvement in people' s livelihood that comes along with China' s accelerating economic development. We had researched the two networks construction of rural drug and gained a widespread popularity among local government, proprietors and farmers in Hunan Province. Construction of rural two networks of drug makes farmers buy drug at ease and ensure the safety of drug use and is deeply welcome by local government and farmers.Objectives:(1). To study the status of drug supervision network and supply network in Hunan Province, analyze existing problems and provide reasonable advices for their progress.(2). To understand the quality of medicine and the changes in drug price in Hunan Province.(3). To formulate the suitable evaluation index system for drug supervision network and supply network in Hunan Province, and quantify the index.(4). To construct an evaluation model for drug supervision network and supply network in Hunan Province with comprehensive evaluation method.Methods:1. Current situation analysisAn on-the-spot investigation and evaluation w as conducted on two nets construction of14cities in Hunan province from2008to2010. We analyzed on the current situation of main drug supervision network coverage, coordinators and information of14cities in Hunan province. We also investigated the supervision work of drug supply, drug distribution network coverage, personnel, distribution mechanism, construction situation of adverse drug reaction, medical device adverse reactions, drug abuse, drug inspection crackdown as a reflection of the drug in Hunan province " two netwoks" construction status indicators.2. Delphi MethodThe Delphi questionnaire design expert consultation was used in our research. Totally20experts who engaged in drug supervision and management of enterprise management, drug or medical teaching scored the importance of each index.20experts also complete a judgment and the degree of familiarity of the authoritative expert opinion questionnaire by self evaluation method.3. The establishment of the comprehensive evaluation modelThe comprehensive evaluation method was used to construct an evaluation model. The comprehensive evaluation method is based on expert evaluation method. Firstly, the necessary evaluation indexes were selected according to the evaluation purpose and the characteristics of the objects. Each index set assessment grades and each grade standard scores indicated. Secondly, the weight of each index, accumulative scores and the scheme of comprehensive evaluation grade of total value range were selected. Finally, the total scores were got by S=(?)WiSi. The analysis and evaluation were conducted to determine the degrees through the total scores.Results:(1). The coverage of drug supervision network and supply network had reached100%in Hunan Province. The number of drug distribution mechanism and person is increasing constantly. The levels of quality control of drugs had gradually improved.(2). The drug prices had declined year after year. The wholesale prices of drug were16.37%in average in2008. It is gradually rising which was17.31%in2009,19.27%in2010respectively. The plus rate of wholesale prices of drug was dropped which was15.11%in2008,14.60%in2009and12.27%in2010respectively. The plus rate of use price of drug was also dropped gradually which was40.87%in2008,26.19%in2009and22.47%in2010respectively.(3). We had built an expert evaluation method as the structure of drug supervision-drug supply-network performance. It included8level two indexes,56level three indexes in the evaluation index system; A comprehensive evaluation model is established on the basis of comprehensive scores received from the Index System; In expert consultation,each level indicators'expert judgment coefficient,familiarity coefficient and authority degree coefficient are above0.7,expert coordination coefficients in level one,level two,level three indicators were respectively0.8023,0.7552and0.6741,3level one indicators weights were34.058%,34.420%and31.522%.(4). The comprehensive evaluation model designed by this research is implemented to conduct an empirical study in14cities of in Hunan province.The rank from good to bad is Hengyang, Zhangjiajie, Yongzhou, Zhuzhou, Changsha, Xiangxi, Chenzhou, Yueyang, Huaihua, Xiangtan, Shaoyang, Yiyang, Loudi, Changde. The rank of weighted RSR method was Hengyang, Yongzhou, Zhangjiajie, Changsha, Zhuzhou, Chenzhou, Shaoyang, Changde, Xiangxi, Huaihua, Loudi, Yueyang, Xiangtan, Yiyang. It was a positive correlation between the results of the comprehensive evaluation model and that of weighted RSR method. The correlation coefficient was0.780(p<0.01). The rank of weighted RSR method is weighted RSR file sort results for:the file (Hengyang, Yongzhou, Zhangjiajie, Changsha), intermediate (Zhuzhou, Chenzhou, Shaoyang, Changde, Xiangxi, Huaihua, Loudi, Yueyang), the next file (Xiangtan, Yiyang). The result of the comprehensive evaluation model was in accordance with that of weighted RSR method. The rank from good to bad was2010,2009and2008.Innovation:(1). We analysed the status of drug supervision network and supply network in Hunan Province and compared the quality of medicine and the changes in drug price in Hunan Province.(2). We had firstly formulate the suitable evaluation index system for drug supervision network and supply network in Hunan Province and determined the levels of index weight distribution and specific tax scale.(3). We firstly construct an evaluation model for drug supervision network and supply network in Hunan Province. We also compared the status of drug supervision network and supply network in14cities in Hunan Province. We also compared those of Hunan Province among2008,2009and2010. We concluded that the research model of comprehensive evaluation was feasibility and maneuverability.Conclusions:(1) At present, the construction of drug supervision and supply networks has come into an advanced stage and the coverage-rate of drug "2S" networks has reached100%, with a decreasing number of villages which are not accessible to the networks. The number of people who work for the networks and agencies that provide drugs has been increasing constantly. The quality of drugs has improved and the prices of which have decreased.(2) Expert-consultation method was used in this study to establish primary evaluative indexes for the assessment of the construction of the networks, The method was proved to be scientific and practical.(3) Scientific method and assessment were introduced to determine the weight of each evaluative index, with scoring regulations and evaluative factors in detail. Formula for synthetical evaluation was put forward: S=(?)WiSi. A model for synthetical evaluation was established based on the comprehensive scoring method, which is considered to be very practical. |
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