| Research purpose:To clarify the structure and logical relationship of drug welfare effect system for patients with chronic diseases,and to establish a system dynamics model of drug welfare effect Based on the clear theoretical mechanism,by using the theory and method of system dynamics,and under the statistical data of field investigation by the research group,the influencing factors of drug welfare effect are further summarized,the main variables and parameters of the model are estimated,and Vens is used.To provide the basis for optimizing the corresponding health poverty alleviation policies,the strategies to improve the welfare effects of drugs for chronic diseases were put forward.Research methods:By analyzing the influence of drug welfare effect on chronic disease patients,the causality diagram/flow chart of each influencing factor and drug welfare effect was drawn.In the three subsystems of drug accessibility,drug price and drug equity,the logical relationship between influencing factors and drug welfare effects is described and analyzed Based on the research data of the research group,the variable nature of the indicators and the corresponding parameter settings are sorted out.VensimPLE6.4 software is used to draw the system flow chart,assign variables to build the system model,and finally analyze the simulation results of the modelResearch results:(1)based on system dynamics modeling and simulation of dynamic results get chronic disease drug welfare effect,and get the related fectors influencing satisfaction dynamic simulation results,can see people with chronic diseases medicine welfare effects of different ages are different^and in terms of drug prices and drug fair satisfaction,town of chronic patients and patients with chronic diseases in rural areas are bigger difference,and presumably drugs welfare effect to chronic diseases patients.(2)according to the team construction of chronic disease drug benefits effect evaluation index system,this paper set up five different fectors affecting the simulation scheme of various indicators of drugs in patients with chronic diseases,the influence degree of the welfare effect,through sensitivity analysis,found that drug welfare effect of patients with chronic diseases are the main factors affecting the drug price satisfaction,followed by the effects of drugs,medicines,and of fairness and drugs.(3)in the policy simulation,the "4+7" urban drug centralized procurement policy of two-ticket system has an impact on the drug welfare of patients.Compared with the impact of the two-ticket system on the terminal price of drugs,the effect of urban drug centralized procurement policy on drug welfare is more obvious.Effective adjuvant drug therapy is beneficial to the prognosis of patients,while unreasonable adjuvant drug therapy may aggravate the condition of patients,and even endanger the safety of patients’ lives.When the proportion of adjuvant medication is 20%,the rational medication can be better promoted,thus inproving the drug welfare of patients.When the basic drug subsidy increased by 15%,the patients’ drug welfare effect was the best.Research co nclusio ns:According to the results of system simulation and intervention,it is found that the key influencing factor of drug welfare effect for patients with chronic diseases is drug price.Therefore,corresponding promotion strategies are proposed around drug price.Formulate drug compensation strategy for chronic diseases.Centralized drug procurement forms the payment standard for medicare drugs.It is suggested to strengthen the supervision and control of drug production,circulation and sales,control drug purchase price and improve the efficiency of drug purchase.At the same time,it is suggested that each country should perfect relevant drug price control laws and regulations and strengthen the supervision of drug pricing process.Control the price markup of essential drugs in medical institutions so as to effectively control the retail price of essential drugs. |
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