Study On Status And Countermeasures Of Essential Medicine Centralized Procurement In Grass-root Health Institution

Essential medicine or drugs bear the primary health care system to establish a major responsibility is to solve "the drugs to support medical" system, maintaining people's health a major reform initiatives. Responsible for determining the nature, this article will focus on procurement of essential drugs essential drugs policy placed to explore the use of primary health care and health institutions of the centralized procurement of essential drugs. Essential drug system is provided by the Government of the masses of public goods, the government is the main body of the basic drug system, supply of essential drugs is also key to the supply of private and government combined model, that the process in the provision of essential drugs and medicines produced by the Government procurement contracts signed by enterprises, pharmaceutical manufacturers responsible for the production of essential drugs, government bidding, procurement and then by the government-run primary care health providers to the people. From the current point of view, China's pharmaceutical market circulation disorder, commercial "rebate" breeding behavior, as well as primary health care sector "to drugs to support medical" serious, primary use of drugs and other issues worrying the existence of quality, leading to the urgent need to standardize the procurement of essential drugs.The age of 90 from the 20th century began to explore the centralized procurement of drugs, and in 2000 to launch a nationwide centralized drug procurement. During the centralized procurement of pharmaceuticals have been some successes, but some issues still outstanding. First, the centralized procurement model confusion in the past, the policy can't meet the new requirements of essential drugs. In the past 20 years exploring the centralized procurement of drugs, China has experienced dozens of procurement, has made many achievements, but mainly for the county and its medical and health institutions above the county executive, after the implementation of essential drugs, primary health care institutions into the scope of centralized purchasing, centralized purchasing of new request. Second, the current centralized procurement issues still outstanding, less than exploit the advantages of centralized procurement. Mainly in the centralized purchasing for the price of alienation, significant differences between bid prices, only the amount of strokes do not recruit qualified secondary bargaining, the parties to actively participate in the lack of centralized procurement, the implementation of centralized procurement of essential drugs is not ideal.In 2009, the country started to implement the basic drug system, while in 2000 the implementation of centralized procurement of drugs policy a complete and sound.2010, the state issued a government-run primary health care institutions to implement the procurement of essential drugs essential drugs guidance for grassroots medical institutions for the procurement of essential drugs proposed new requirements, adjusting the urgent procurement of essential drugs. The comparative analysis of basic drugs in the market circulation and centralized procurement history and development status, based on primary health care institutions in Jilin Province as field research object, by region 15 samples randomly selected pilot counties,93 primary health care institutions (including 68 township hospitals,25 community health service centers); 15 samples of non-pilot counties,79 primary health care institutions (of which 55 township hospitals, community health service centers 24). And interviewed a large number of samples of primary care health institutions affiliated health, finance, social security and other departments insider, Jilin Pharmaceutical Procurement Service Center and the provincial health, finance, human security and other departments, other provinces centralized procurement of essential drugs agencies, and pharmaceutical production and trade corporate insiders, as well as outpatients and inpatients within the sample of patients, medical staff. The questionnaire will collect information through sorting, statistical analysis methods such as sorting, analysis, centralized procurement of essential drugs following conclusions:Centralized procurement of essential drugs proposed by the general principles. General principles:adhere to government-driven market mechanism combined with the centralized procurement of basic ideas, adhere to quality first, reasonable price and the basic principles of play focus on bulk purchasing advantages, protection of basic medical supplies, the establishment of national essential medicines reserve system, to achieve basic drug safety effective, good quality, reasonable price and timely supply to ensure that the people truly affordable.Proposed the establishment of a new pattern of centralized purchasing model. New model are:to build a reasonable comprehensive evaluation system for basic drug evaluation, the establishment of provincial "unified distribution, unified billing," distribution model, the implementation of "with the amount of purchase, point production, simplified packaging", the centralized procurement of essential drugs selection evaluation. Throughout the process the procurement of essential medicines and improve long-term supervision mechanism, strengthen the supervision and management of successful results.Centralized procurement of essential drugs for the establishment of protection measures. Basic drugs, the government in a dominant position, should strengthen the publicity and guidance relevant policies, increase government investment, the establishment of primary health care institutions, "expenditure" management style, give full play to the role of financial reveal all the details play an important compensation insurance fund effect. At the same time, improve the management of primary health care and health institutions, health institutions to strengthen primary health care workforce, and promote maximum efficiency of centralized procurement of essential drugs.Resources as public goods to avoid the "tragedy of the public", for the essential drugs system and the centralized procurement of essential drugs policy, only when the policies promoted simultaneously in order to maximize its benefits. Although the progress of exploration, full of hardships, but only if we analyze the situation, identify the problems, to innovate, centralized procurement of essential drugs is to promote the essential drugs system will be the most powerful means to ensure people's health is a major strategic policy.