Analysis And Evaluation Of The Implementation Effect Of Centralized Procurement Of State-organized Drugs In A District-level Public Hospital In Wuhu

Objective:To evaluate the implementation of the policy of the first,second and third batches of state-organized centralized drug purchase（hereinafter referred to as"national centralized drug purchase"）in a district-level public hospital in Wuhu,and to provide reference for promoting the rational use of selected drugs,improving various medical insurance policies and promoting the linkage reform of the three hospitals in this area.Methods:Compared with the prices of the unselected varieties under the same generic name of the first three batches of national collectived-purchase drugs selected and used in the hospital before the implementation of the policy,the decrease of drug prices before and after the implementation of the collectived-purchase policy was obtained.The procurement data of the first,second and third batches of national drug centralized procurement in Anhui Province was used to check the procurement completion of the selected varieties and calculate the procurement completion ratio.The distribution rate is calculated by the actual distribution quantity of each selected variety of the distribution company;Using the sales data of selected varieties in the hospital information system to calculate the sales rate and monitor the actual completion of three batches of selected varieties in the hospital district;The average outpatient drug cost was collected from the HOSPITAL’s HIS system to know whether the economic burden of patients was really reduced before and after the implementation of the policy.Among them,the procurement percent complete=(the actual purchase/contract purchase amount^[1])x 100%,agreed to purchase quantity one year is the same doses of the same generic names drug actual purchase quantity60%～70%,according to the minimum use of packaging（piece/package/bag/）to purchase the total conversion^[2],the sales completion rate=（sales/agreed purchase quantity）by 100%,Delivery rate=（actual delivery/actual purchase）×100%,average outpatient drug cost=total outpatient drug cost in a certain period of time/total outpatient visits in the same period^[3].Results:1.The selected drugs in the first three batches of a district-level public medical institution in Wuhu completed the agreed purchase quantity on time,and the purchase completion ratio was over 100%,among which lipid-lowering drugs,antihypertensive drugs,antiglycemic drugs and other chronic diseases were the main drugs,which were consistent with the drug use characteristics of district-level hospitals.2.In the procurement cycle,the delivery rate of some varieties is low,and the sales progress of some selected varieties is lagging behind.Actively find out the reasons and take measures,actively communicate with the distribution company for the problem of low delivery rate,and feedback the scoring results of the company with low delivery rate to the superior competent units,and implement punishment measures;In view of the problem of poor sales of some varieties,the use of similar non-selected drugs should be monitored first,and measures such as limited use or discontinuation should be taken.The task quantity should be finely allocated to each department,requiring all departments to give priority to the use of selected drugs under the condition of ensuring clinical needs,and continuous supervision should be conducted.3.From 2019 to 2021,the average outpatient drug cost was 66.68 yuan,61.38 yuan and 51.79 yuan,respectively.The outpatient drug cost decreased year by year before and after the implementation of the collective procurement policy,reducing the burden of patients and saving medical insurance funds.Conclusion:The implementation of the first three batches of national drug collection in a district-level hospital in Wuhu has achieved certain results,which effectively reduced the drug burden of patients,effectively saved the medical insurance fund,and promoted the rational drug use in the hospital.However,in the early stage of implementation,there was a lack of understanding of the policy,the management was not fine enough,and the administrative intervention was obvious.It is suggested to improve the system of reporting the agreed purchase quantity of national collective procurement drugs.Optimizing the rational use of selected drugs and non-selected drugs;Actively do a good job in the publicity of national centralized drug collection;To strengthen the role of pharmacists in the national centralized drug collection work;We will strengthen tracking of the quality stability of drugs collected by the state.