Quantitative evaluation of “dual channel” management policy of national medical insurance negotiation drugs based on PMC index model

GAO Wenping; WANG Shuling

doi:10.6039/j.issn.1001-0408.2024.19.03

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Quantitative evaluation of “dual channel” management policy of national medical insurance negotiation drugs based on PMC index model

更新时间：2024-10-11

- Quantitative evaluation of “dual channel” management policy of national medical insurance negotiation drugs based on PMC index model
- ZHONGGUO YAOFANG Vol. 35, Issue 19, Pages: 2335-2339(2024)
- 作者机构：
  
  沈阳药科大学工商管理学院，沈阳　110016
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2024.19.03
  CLC： R95
- Published：15 October 2024，
  
  Received：17 March 2024，
  
  Revised：19 July 2024，
- 稿件说明：
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高文萍,王淑玲.基于PMC指数模型的国谈药品“双通道”管理政策量化评价 ^Δ[J].中国药房,2024,35(19):2335-2339.

GAO Wenping,WANG Shuling.Quantitative evaluation of “dual channel” management policy of national medical insurance negotiation drugs based on PMC index model[J].ZHONGGUO YAOFANG,2024,35(19):2335-2339.
高文萍,王淑玲.基于PMC指数模型的国谈药品“双通道”管理政策量化评价 ^Δ[J].中国药房,2024,35(19):2335-2339. DOI： 10.6039/j.issn.1001-0408.2024.19.03.

GAO Wenping,WANG Shuling.Quantitative evaluation of “dual channel” management policy of national medical insurance negotiation drugs based on PMC index model[J].ZHONGGUO YAOFANG,2024,35(19):2335-2339. DOI： 10.6039/j.issn.1001-0408.2024.19.03.

摘要

目的

对省级层面国家医保谈判药品“双通道”管理政策进行量化评价，分析不足之处和优秀经验，为该类政策的优化提供参考。

方法

以31个省份国家医保谈判药品“双通道”管理政策为研究对象，运用文本挖掘法，归纳政策重点内容；构建政策一致性（PMC）指数模型，通过评价模型从整体角度对31个省份“双通道”管理政策进行量化分析；并以北京市和重庆市为例，对比优秀政策与可接受政策的差异性。

结果

31个省份中，18个省份的政策PMC指数介于6.00～＜8.00，属于优秀政策；13个省份的政策PMC指数介于4.00～＜6.00，属于可接受政策。北京市和重庆市的政策在政策性质、政策时效等5个层面保持一致，而在政策内容、政策受众等4个层面存在差异。

结论

多数省份“双通道”管理政策处于较为完善的水平。部分省份后续还需根据本省医药卫生发展实际情况，持续优化政策设计，完善政策细则；搭建定点药店管理模式，明确遴选规则与退出机制；重视药学服务建设，推动处方外流。

Abstract

OBJECTIVE

To quantitatively evaluate the “dual channel” management policy of national medical insurance negotiation drugs at the provincial level， analyze the shortcomings and excellent experience and provide reference for the optimization of the policy.

METHODS

Taking the “double-channel” management policy of national medical insurance negotiation drugs in 31 provinces as the research object， text mining method was used to summarize the key contents of the policy； the policy modeling consistency （PMC） index model is constructed， and the “dual channel” management policies of 31 provinces are quantitatively analyzed through the evaluation model. Taking Beijing and Chongqing as examples， the differences between good policies and acceptable policies are compared.

RESULTS

Among the 31 provinces， the PMC index of 18 provinces is between 6.00 and ＜8.00， which belongs to the excellent policies. The PMC index of 13 provinces is between 4.00 and ＜6.00， which belongs to acceptable policies. The policies of Beijing and Chongqing are consistent in 5 aspects， such as policy nature and policy effectiveness， while there are differences in 4 aspects， such as policy content and policy audience.

CONCLUSION

The “dual channel” management policies in most provinces are at a relatively perfect level， and some provinces need to continuously optimize the policy design and improve the policy rules according to the actual situation of their own medical and health development； establish the management mode of designated pharmacies， clarify the selection rules and exit mechanism； pay attention to the construction of pharmaceutical care， and promote the outflow of prescriptions.

关键词

国家医保谈判药品双通道PMC指数模型文本挖掘法政策研究量化评价

Keywords

dual channelPMC index modeltext mining methodpolicy researchquantitative evaluation

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