J. Research On The Effect Evaluation Of The Implementation Of The Drug Reform Policy In Public Hospitals

《The Opinions on Deepening the Reform of the Medical and Health System issued》by the CPC Central Committee and the State Council since 2009 marked the official launch of a new round of medical reform,and the Opinions "establish and improve the drug supply security system" indicate the basic path for the healthy development of the field of drug circulation.In this direction,in March 12,《the "12th Five-Year Plan" to deepen the medical and health system reform planning and implementation of the program notice》、16 December《 "13th Five-Year Plan" to deepen the medical and health system reform of the notice》in a series of drug circulation policies show obvious phase characteristics.Public hospitals,as the "last mile" of medical reform,whether their drug supply is timely,whether the drug price is inflated and reasonable is a direct manifestation of the effect of policy implementation in the field of drug circulation,and it is also one of the important contents of deepening the reform of public hospitals and implementing Healthy China 2030,which is of great research significance.This paper collects the national drug reform policies that J Public Hospital has mainly implemented since the new medical reform in 2009.Taking the three main indicators of drug availability,affordability and rational drug use as dimensions,it uses the content analysis method to analyze each The frequency of indicators in the policy,and extracts seven secondary indicators of drug price,average drug cost,drug variety,proportion of basic drugs,consumption structure changes,antibiotic use and proportion of drugs.At the same time,from J Public Hospital HIS The drug data from 2009 to 2019 is extracted from the system,sorted by department,drug type,method of use,etc.,and the data changes of various indicators during the implementation of the drug reform policy in J public hospitals are analyzed by SPSS25.0 software.Attempt to evaluate the effect of drug reform policy in grassroots hospitals,combined with field interviews,in-depth evaluation of the implementation of drug reform policy in grass-roots public hospitals,summarize problems,analyze the reasons and make corresponding recommendations.Through the analysis of the sample data of J Public Hospital,it can be concluded that: First,the effect of policy implementation is generally good.In the three stages of the policy,the implementation effect has improved significantly in the first two stages,and has gradually stabilized since then.The performance in the third stage was slightly weaker,the proportion of base drugs and the use of antibiotics,Medicine and other indicators still have a large gap with developed countries,indicating that there is still much room for policy advancement.The second is that the people’s medication environment has improved.Since the implementation of the policy,the hospital’s three major indicators of drug affordability,drug availability,and rational drug use have all improved to a certain extent,mainly reflected in the control of sub-average costs,the use of drugs tends to be reasonable,and the proportion of antibiotics used has also been obvious The decline indicates that the policy objectives of controlling the medical expenses of the whole people,improving the people’s medication environment,and strengthening the rational use of medicines have been implemented.The third is that the improvement of hospital operation efficiency is not obvious.Although the proportion of self-financed medicines in the hospital and the overall price of medicines have been reduced,people’s consumption structure has tended to be reasonable,and the medical burden has improved,but the problem of "hospitals subsidizes thier medical services with overly expensive drug prescriptions " has not been fundamentally solved,and the proportion of medical insurance medicines remains high To a certain extent,it affects the quality and efficiency of hospital operations.Based on the above analysis and on-site interviews,the following three issues were summed up: First,people still feel "difficult and expensive to see a doctor";second,the hospital’s operating efficiency is not ideal;third,there are price increases and out of stocks of some medicines.After research and analysis,there are mainly the following reasons: First,the transfer of hospital income sources has not significantly reduced the burden on people to see doctors;Second,the lack of policy compensation mechanisms has caused the hospital’s operating efficiency to be hardly improved;Third,the evaluation index of rational drug use There is still room for improvement;Fourth,the supervision mechanism in the process of policy implementation is incomplete;Fifth,the awareness of the drug reform policy is not very popular.In response to the analysis of the above problems,this article puts forward the following suggestions: First,optimize the comprehensive operation and management of the hospital;Second,improve the government compensation mechanism;Third,establish and improve the comprehensive evaluation system of drugs;Fourth,strengthen the government supervision and management;Fifth,increase publicity and training efforts.