Evaluation On The Implementation Effect Of "Two-invoice Policy" In Drug Purchase In Hefei Public Medical Institutions

Objective: Through understanding the background of the implementation of the“two-invoice policy” for drug procurement and the implementation measures of relevant policies,analyzing the current drug supply situation in our country,and exploring the potential risks in the implementation of policies,the study proposes corresponding countermeasures for the continuous improvement of the new medical reform system.Exploring the implementation status of the "two-invoice policy" of public hospitals in Hefei,analyzing the impact of policies on public hospitals,pharmaceutical manufacturers,drug distribution enterprises and the impact of other policies on public hospitals,the study proposes corresponding countermeasures and suggestions for the improvement of the policy system.Methods: Seven public medical institutions in Hefei were selected as research objects,and HIS systems of these four medical institutions were used to collect the drug purchasing data two years before and after the implementation of the “two-invoice policy”,namely the relevant drug purchasing data in the HIS system for the whole year of 2015 and 2017.The distribution information of two sample hospitals were Collected,and the information that distribution enterprises distributed drugs to different hospitals were classified and summarized.This study proposes corresponding countermeasures and suggestions for changes after the implementation of the “two-invoice policy”.Questionnaire interviews were conducted with the relevant responsible persons of seven medical institutions.The questionnaire involved the general situation of theimplementation of the “two-invoice policy” for drug procurement and the impact of policies on medical institutions.Results:1.Amounts of distribution expenses increased significantly in the top 18 kinds of drug purchasing information after the implementation of the “two-invoice policy” for drug procurement in four public medical institutions in Hefei.Among the top 72 kinds of drugs in these four public medical institutions,the price of 18 kinds of drugs decreased,the prices of 7 kinds of drugs increased,and the prices of 47 kinds of drugs remained unchanged.2.Situations are different for drug distribution enterprises distributed drugs to different medical institutions.Some small-scale distribution enterprises have gradually disappeared after the implementation of the “two-invoice policy” for drug procurement.3.The average outpatient service cost and the average drug cost of the outpatient service increased after the implementation of the policy of the provincial representative sample points,on the other hand,the average hospitalization cost and the average drug cost of hospitalization decreased.Among the 1185 drugs be surveyed,467 kinds of drugs reduced in price,accounting for 39.21% of the total number of drugs.The distribution rate fluctuated between increasing and decreasing during 2015-2018,and the overall trend is on the rise.4.Through interviewed with relevant responsible persons,five of these hospitals indicated that the “two-invoice policy” bills were checked in the most traditional way,that is,the manual one-on-one check;there is no mature electronic inspection system,and the workload is more than before the policy implementation.At the same time,there are some short supplied drugs because they cannot meet the policy requirements.Most hospitals believe that the implementation of policies improved the supply of drugs,shortened the distribution time of drugs,had a positive effect on the optimization of drug distribution processes,and reduced the price of drugs.Conclusion:1.After the implementation of the ' two-invoice policy'' for drug procurement,the market concentration have increased.The combined implementation of the ' zero-plus' ',the centralized procurement of drugs,the ' two-invoice policy'' and other measures have a certain positive effect on the reduction of drug prices.2.Through data analysis and interviews with relevant responsible persons,exploring the problems existed in the implementation;this study puts forward corresponding policy recommendations for the research results of the “two-invoice policy” for drug procurement,and provides reference for promoting the development of medical undertakings.