贵州医科大学学报

2016, v.41;No.190(07) 790-792+796

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贵州省不同等级医疗机构基本药物购销价格差异
Analysis of Transaction Price Difference of Basic Medicine in Different Levels Medical Institution in Guizhou Province

陈美;宋沈超;范彩屏;陈梅;黄贵军;靳帅;肖志文;龙丽荣;
CHEN Mei;SONG Shenchao;FAN Caiping;CHEN Mei;HUANG Guijun;JIN Shuai;XIAO Zhiwen;LONG Lirong;Departemnt of Infectious Disease,the Third People's Hospital of Bijie;Departemnt of Preventive Medicine,School of Public Health,Guizhou Medical University;School of Social Sciences,Guizhou Medical University;Vocational and Technical College of Bijie;

摘要(Abstract):

目的:分析贵州省不同等级医疗机构基本药物随机购销价格的差异。方法:采用分层随机抽样方法,抽取贵州省95家医院,其中基层医院65家、县级医院17家、市州级医院11家及省级医院2家;发放自制"贵州省基本药物使用情况表"对各医院药房进行调查;使用Kruskal-Wallis检验比较各医院基本药物购销价格的中位数,采用Pearson相关分析采购价与绝对利润的关系,线性趋势检验和spearman等级相关分析各医院各价格基本药物的组成情况。结果:回收问卷95份,回收率100%;省级医院基本药物的购销价格明显高于下级医院,各医院基本药物购销价格不同,差异有统计学意义(P<0.05);省级医院、市州级医院、县级医院、基层医院10元及以下的基本药物所占比例均较高,占比48.3%~76.6%;Pearson相关分析显示基本药物采购价格越高,绝对利润越大,采购价与绝对利润呈正相关(r=0.96,P<0.05);线性趋势检验和spearman等级相关分析显示基本药物价格构成与医疗机构等级呈线性趋势和等级相关,随医疗机构等级升高,配备的基本药物中高价药所占比例逐步增加(P<0.05)。结论:贵州省不同等级医疗机构基本药物购销价格存在差异,在基本药物构成中10元以下所占比例均较高;等级较高的医院随医院等级升高,配备的基本药物中高价药比例大。
Objective: To analyze purchasing and sale price of medicine in different levels of hospital in Guizhou province in order to explore the causes of high drug prices. Methods: Adopting the stratified random sampling method,taking 95 hospitals into research,65 basic-level,17 county level,11 city hospitals and two provincial hospitals. Distributing DIY " Guizhou province basic drug use situation table" to the hospital pharmacy. Adopting the Kruskal-Wallis test to compare the median of hospital medicine purchase and sale price,adopting the Pearson correlation to analyze procurement price relationship with absolute profit,using linear trend test and Spearman rank correlation to analyze the composition of basic medicine. Results: Retrieving 95 questionnaires,recovery rate was 100%. Provincial hospital medicine purchase and sale prices were significantly higher than the supervising hospital in Guizhou province; medicine purchase and sale price were different,Kruskal-Wallis test showed P <0. 05,the difference was statistically significant. In provincial,city,county and primary hospitals,10 yuan and cheaper basic-level medicine accounted for a higher proportion,ranging from 48. 3% to76. 6%. The higher the medicine purchase price was,the higher the absolute profit was. Purchase price and absolute profit was positively correlated( r = 0. 96,P < 0. 05). Linear trend test and Spearman level correlation analysis indicated that basic medicine price composition and level of medical institutes exhibited linear trend and levels correlated; with the greater of the medical institute,high price medicine among basic medicine accounted for gradual increasing proportion( P < 0. 05). Conclusions: Significant difference exists among types of basic medicines used by different levels of medical institutes. Preference for expensive medicine helped drug prices artificially high. Breaking the monopoly of public hospitals is the only way to completely solve the " drug income supplement the doctor's income" system,and then fundamentally solve the problem of drug prices artificially high.

关键词(KeyWords): 医疗机构;基本药物;价格差异;药价虚高
medical institution;basic medicine;price difference;artificially high medicine price

Abstract:

Keywords:

基金项目(Foundation): 贵州省科学技术厅联合基金计划项目[黔科合LG字(2012)020]

作者(Author): 陈美;宋沈超;范彩屏;陈梅;黄贵军;靳帅;肖志文;龙丽荣;
CHEN Mei;SONG Shenchao;FAN Caiping;CHEN Mei;HUANG Guijun;JIN Shuai;XIAO Zhiwen;LONG Lirong;Departemnt of Infectious Disease,the Third People's Hospital of Bijie;Departemnt of Preventive Medicine,School of Public Health,Guizhou Medical University;School of Social Sciences,Guizhou Medical University;Vocational and Technical College of Bijie;

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DOI: 10.19367/j.cnki.1000-2707.2016.07.011

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