| BackgroundEssential medicines are directly related to people’s health.The level of essential medicines’ supply guarantee directly affects the level of medical services,which is vital to safeguarding people’s health rights.It is of great significance to guarantee the supply of essential medicines.The current situation of the shortage of essential medicines in my country is severe,and the problems of difficult and expensive medical treatment have not been solved.The rapid growth of medical expenses has attracted widespread attention from all walks of life.It is even more important to improve the supply of essential medicines to meet people’s demand for medicines.In order to effectively realize the overall requirements of basic protection,strengthening of the grassroots level,and establishment of mechanisms,the state currently has clear regulations on the use of essential medicines.Therefore,it is urgent to study the supply guarantee capacity of essential medicines.Based on this,this study provides policy support for improving the essential drug system by analyzing and researching the procurement data of essential drugs in Shandong Province.ObjectiveThis study analyzes the changes in the procurement and supply capacity of essential drugs in Shandong Province from 2016 to 2019,studies the current situation of the supply of essential medicines,analyzes existing problems,explores the factors affecting the guarantee of essential medicines,and provides policy recommendations for promoting the use of essential medicinesMethodsThis research mainly includes documents collected from domestic data platforms such as China Knowledge Network(CNKI)and key foreign databases such as Pubmed,Web of Science,etc.;and documents related to essential drugs collected from official websites at home and abroad such as WHO,National Health Commission,etc.Policy documents for China;second-hand data collected from official statistical websites and China Health Statistics Yearbook;2016-2019 essential drug procurement data obtained from the Shandong Pharmaceutical Centralized Procurement Platform and qualitative data obtained from interviews with various stakeholders.This study uses a combination of quantitative and qualitative analysis methods.Quantitative data mainly uses descriptive analysis methods.The procurement status is measured by two indicators:the drug product procurement ratio and the amount procurement ratio;the supply situation uses the total arrival rate and the three-day arrival rate measure.The focus is on cardiovascular system drugs and 5 anti-tumor drugs,among which the frequency,availability and delivery rate of anti-tumor drugs are selected for analysis.The influencing factors were analyzed by multiple regression analysis.Qualitative data mainly uses thematic framework method to summarize and summarize.Stata16.0,ArcGIS10.2 and Nvivo10 were used for data processing and analysis throughout the process.ResultThe procurement proportion of essential drugs in Shandong Province is relatively high,reaching 96.35%,and the proportion of product-regulation procurement is 62.34%,and the overall procurement proportion is gradually increasing.The proportion of purchases of western medicines is relatively high,but the proportion of purchases of traditional Chinese medicines has increased rapidly.In 2019,the proportion of purchases of Chinese medicines was 95.90%,and the proportion of purchases of western medicines was 93.53%.The proportion of essential medicines purchased by medical institutions at all levels has continued to increase,and the proportion of purchases by second-level hospitals is relatively high.In 2019,the proportion of purchases reached 92.55%.The difference in the proportion of essential medicine purchases between regions is small,and the overall trend is increasing.Among them,economically underdeveloped regions have a faster growth rate.In 2019,the proportion of essential medicine purchases in each region exceeded 90%.The purchase amount of essential medicines continues to rise,and the purchase amount in 2019 is approximately twice that of 2016.The proportion of the purchase amount of traditional Chinese medicine in the total amount has been decreasing year by year,from 30.77%in 2016 to 17.65%in 2019.The purchase amount of essential medicines by medical institutions at all levels has continued to increase,with tertiary medical institutions growing the fastest.In 2019,the purchase amount of tertiary hospitals accounted for 48.11%of the total amount.The purchase amount of essential medicines per capita in various regions of Shandong Province is increasing year by year,and its average annual growth rate is basically positively correlated with its economic development level.The per capita purchase amount in economically developed regions has grown the fastest.In 2019,the per capita purchase amount exceeded 1,100 yuan,with an average annual growth rate of nearly 30%.There is a large gap in the purchase amount of essential medicines per capita between regions with different economic development levels.The average annual total delivery rate of essential medicines in Shandong Province is 94.12%,showing a trend of first increasing and then decreasing;the average annual three-day delivery rate of 45.48%,showing a trend of first decreasing and then increasing.The proportion of cardiovascular system drugs purchased was 97.92%,and the purchase amount of statins and anti-heart failure drugs increased the most.There are 33 types of anti-tumor drugs purchased.Among them,the purchase amount of anti-tumor drugs has increased rapidly,from 404 million yuan in 2016 to 1.333 billion yuan in 2019.The multi-factor analysis results show that factors such as the type of drugs,medical insurance drugs,hospital grades,and regional economic development levels all have an impact on the purchase amount of essential drugs.Among them,the differences between the categorical variables are large,and the differences between the groups are statistically significant.Conclusions and SuggestionsShandong Province’s basic drug supply guarantee capacity is at a relatively high level,with a complete range of procurement and a relatively high proportion of equipment;the amount of basic drug purchases has increased rapidly,and the overall structure is concentrated and basically stable.The proportion of basic medicine types and purchase amount in primary medical institutions have increased rapidly,but their purchase amounts are still quite different from those of other medical institutions.There are big differences in the types and amount of essential medicines purchased in different regions,and the level of regional equipment is basically proportional to the level of economic development.The overall arrival rate of essential medicines in Shandong Province is relatively high,but the timeliness of supply is low.The three-day arrival rate and the total arrival rate are very different,but the three-day arrival rate has shown an upward trend in recent years.Based on the above conclusions,in order to further improve the ability to guarantee the supply of essential drugs,this study puts forward the following recommendations:(1)Improve the fund settlement supervision system,and the reward and punishment mechanism will exert two-way force(2)Pay attention to the supply of drugs in secondary hospitals,and urge tertiary hospitals to confirm online in timeStrengthen the basic status of primary hospitals and highlight the priority status of essential medicines(3)Encourage joint procurement across regions and regions to reduce the cost of medication for patients(4)Promote the cultivation of pharmacy talents,promote the sinking of pharmacist resources,and realize safe drug use(5)Promote the cultivation of pharmacy talents,promote the sinking of pharmacist resources,and realize safe drug use... |
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