Effects Of Drug Purchase Policy On Drug Use And Medical Expenses In A Third-grade Hospital In Jiangxi Province

Objective: To study the influence of the implementation of urban drug procurement policy on drug use and medical expenses in Yichun People’s Hospital of Jiangxi Province,a levelA general hospital,and to discuss some problems that may occur in the implementation of the policy,and to give corresponding policies and suggestions.It is expected to provide reference for the formulation of drug policy in prefecture-level public hospitals and drug management in various medical institutions.Methods: The three-level A-level general hospital was selected as the research object to compare the drug use of the hospital before and after the implementation of the drug purchase policy in terms of the variety,structure,quantity and dosage form of each batch of drugs purchased with quantity.The data collected were summarized and analyzed from outpatient and inpatient drug usage,drug repurchase rate of patients before and after drug purchase policy,rational drug use rate of hospitals and changes in medical expenses,combined with literature policy analysis,questionnaire survey on satisfaction of patients and medical staff,and SPSS20.0 statistical software.The composition and change of drug use and medical expenses before and after the implementation of urban drug procurement policy were analyzed from multiple perspectives.Results:(1)By comparing the expected average monthly drug completion amount with the actual average monthly drug completion amount,it can be seen that 18 of the 20 selected drugs in the first batch of drugs overfulfilled the task amount,and 14 of the 19 selected drugs in the second batch overfulfilled the task amount.(2)Two batches of limited quantity procurement have been implemented in this Grade III,Grade A general hospital,and the completion situation is getting better and better,which is reflected in the increase of DDDs growth rate and the obvious decrease of DDC.(3)According to data collection and statistical results,after the implementation of the drug purchase policy in the first batch of drugs,the average cost per time of most drugs decreased from 22.01 %-96.13 % compared with that before the reform;after the implementation of the drug purchase policy in the second batch of drugs,the average cost per time decreased from 17.85 %-99.01 % compared with that before the reform.(4)According to the tracking of the drug use of the patients in the half year after the implementation of the first batch of quantity purchase,the repurchase rate of 4 kinds of drugs increased after the quantity purchase,and there were 7 kinds of drugs that no patients insisted on repurchase.The drug use of patients was tracked half a year after the implementation of the second batch of band-volume procurement.The repurchase rate of 11 kinds of drugs increased after the band-volume procurement,the repurchase rate of 6 kinds of drugs decreased after the implementation of band-volume procurement,and no patients insisted on the repurchase of 2 kinds of drugs.(5)The average qualified rate of prescriptions in the second half of procurement with quantity was generally higher than that in the first half of procurement with quantity,and the situation of rational drug use was improved.(6)The results of the satisfaction questionnaire for patients and medical staff show that patients have a low awareness of and pay little attention to the specific content of this policy.Conclusion:(1)After the implementation of the urban drug procurement policy,the hospital’s drug costs generally showed a certain downward trend,and the implementation of the policy achieved initial results.(2)The three key departments in this study,cardiovascular department,oncology department and hepatitis B infection department,have their own characteristics in terms of treatment and medication,so the hospital should formulate specific implementation norms according to different departments to facilitate differentiated management of each department.(3)Under the guidance of the existing drug policy implemented by the hospital,the drug cost also decreased in accordance with a certain proportion,but compared with the bid-winning drugs,it is still relatively difficult to control the price of unbid-winning drugs.(4)In the procurement of drugs in quantities,pharmacists should focus on monitoring bid-winning drugs with large changes in amount and usage,analyze whether their usage meets the needs of clinical medical work and whether the bidwinning drugs are used rationally,report the problems found in time,and intervene with effective measures and norms.(5)Questionnaire survey found that the medical staff had a high degree of recognition of this policy,and most people had a clear cognition of the job attributes of hospital pharmacists.However,the awareness of procurement policy with volume needs to be improved.