《处方管理办法》与药学专业技术人员执业风险

目的增强药学专业技术人员的法律、法规意识及风险意识，提高防范执业风险能力。方法通过分析《处方管理办法》的部分条文，提出药学专业技术人员在实际调剂过程中可能遇到的风险，并提出相应的建议。结论药学专业技术人员不仅要掌握相关的医药专业知识，还要熟悉相关的法律、法规，用来指导实际工作，解决实际问题，防范执业风险。     

临床药学与医疗风险

临床药学是一门综合性应用型药学分支学科,内容广泛,技术服务性强,它体现了学科渗透、交叉的趋势。随着临床药学的发展,临床药师参与药物治疗的深入,公众医疗保健意识的提高,临床药师要承担药物治疗的责任,医疗风险随之而来。为了提高防范意识,在一定程度上减少医疗风险,笔者就     

临床药师职业风险防范的伦理观照与法律思考

随着我国临床药学工作的普及和不断深入,有关临床药师职责的立法任务也越来越受重视。临床药师存在药学和法学的含义界定、产生背景不清,而临床药师职业中存在着法定权利空泛责任不清、专业地位及流向不明确、对临床药师的认知程度不高等风险,其职业风险防范具有行善、无害、自主、公平原则的伦理观照和立法、守法、司法的法律思考。     

实施风险导向内部审计 防范医院财务风险

文章介绍了医院风险导向内部审计、医院财务风险的含义及医院风险导向内部审计在防范医院财务风险中的作用,对加强风险导向内部审计、防范医院财务风险的对策进行了探讨。     

临床护理工作的风险评估及防范管理

随着临床护理工作的不断拓展,护理风险也在不断增加,为了避免护理纠纷和护理差错的发生,有效提高护理人员的风险防范意识、护理工作质量和患者满意度,我们采取了相应的防范管理措施.本文从护理风险种类、护理风险评估以及防范管理措施三方面进行了分析和总结,提出从强化护理人员的风险意识、增强工作责任感和积极性、建立健全风险防范机制、加强与患者的沟通、提高专业知识和技能等防范管理措施,减少护理风险,提高患者满意度.     

医疗风险防范调控体系研究

医疗风险的防范在医疗风险管理过程中可有效消除不必要风险的发生。目前我国医疗安全管理的实践主要集中在医疗纠纷和医疗事故的处理上．对如何防范风险没有进行深入系统的探讨。本文通过构建医疗风险防范调控体系的基本框架，从行业管理、医疗机构、医务人员、患者、医疗责任保险等方面进行了简要阐述，并时如何降低医疗风险提出了若干建议。     

护患联手共建护理风险安全防范体系

在防范和降低护理风险的管理活动中,护理管理者实施了护患联手进行风险管理的新措施。一方面,明确护理风险管理的重点,完善防范风险的制度,建立优质护理工作流程等管理措施,及时堵塞漏洞;另一方面,将防风险意识渗透于护理活动中,注重培养护士、病人及家属风险防范意识,及时开展贴心的健康教育和护患间有效沟通、履行风险告知义务及对患者进行自我护理培训,这样才能形成护患防范风险的共同体,最终确保患者安全康复出院。     

从典型个案讨论注射泵质量风险源控制

注射泵作为生命支持和药物治疗的辅助装备,其安全使用一直是医学装备质量控制的重点。本文通过对临床不良事件个案分析,从工程技术、医疗护理、临床药学等多方面阐明注射泵质量风险源的发生机理,为注射泵临床应用风险的规避和防范提供理论依据,以不断提高注射泵的应用和操作水平。     

医疗风险防范的思考

医疗风险防范是一种有效的、可操作的质量管理模式。笔者分析新形势下做好医疗风险防范工作的必要性,通过做好防范医疗风险工作的实践,强化医疗风险防范的新思维,针对医疗风险防范提出思考。     

论即时补偿制下新农合基金风险的成因与对策

随着新型农村合作医疗即时补偿制的建立,探讨防范新农合基金风险直接关系到新农合的健康发展.本文对即时补偿制下新农合基金风险产生的主要成因进行了分析,提出了防范基金风险的一些对策.     

Beyond beliefs: risk assessment technologies shaping patients' experiences of heart disease prevention

Social science research on lifestyle-related diseases typically focuses on patients' understandings and beliefs and takes the clinical risk for granted. We interviewed 30 healthy UK patients at high risk of heart disease, recruited from a family history trial at 2 weeks and 6 months after a discussion with a clinician about their risk, lifestyle and medications. The participants took four different paths: (i) pharmaceutical (most common, risk reduction with cholesterol lowering statins), (ii) mixed (statins and behaviour change), (iii) behavioural (behaviour change, focus on wellbeing) and (iv) 'lost' (no prevention, difficult social/personal circumstances). Drawing on Berg we argue that coronary heart disease (CHD) risk assessment technologies are formal tools that generate, rather than represent, high risk in a way that patients often experience lifestyle change as futile, because it rarely reduces their cholesterol to targets defined by the tools. We suggest social scientists studying incipient or 'proto-diseases', such as CHD risk, should not only focus on understandings but also investigate the technologies (and the associated guidelines, policies, clinical practice and pharmaceutical industry operations) that generate incipient diseases and patients' experiences of them. However, technologies do not determine experience and we also discuss elements that direct patients down other than the pharmaceutical path.     

Predictability of drug expenditures: an application using morbidity data

The growth of pharmaceutical expenditure and its prediction is a major concern for policymakers and healthcare managers. This paper explores different predictive models to estimate future drug expenses, using demographic and morbidity individual information from an integrated healthcare delivery organization in Catalonia for years 2002 and 2003. The morbidity information consists of codified health encounters grouped through the Clinical Risk Groups (CRGs). We estimate pharmaceutical costs using several model specifications, and CRGs as risk adjusters, providing an alternative way of obtaining high predictive power comparable to other estimations of drug expenditures in the literature. These results have clear implications for the use of risk adjustment and CRGs in setting the premiums for pharmaceutical benefits.     

医疗风险及其处理方式的探讨

探讨医疗风险处理的目的在于提高医疗风险防范意识，建立合理的医疗风险分担与医疗争议赔偿社会化机制。医疗风险是客观存在的，它具有兼容性、复杂性、危害性等特点。引发医疗风险的因素也是复杂的，常见的有医疗主体因素、医疗客体因素、疾病因素、医疗仪器设备因素等。财务处理两大类。目前，对医疗风险进行保险已势在必行。我们应建立四位一体的医疗风险保险形式，佘正、公平、客观、科学地处理医疗争议，防范医疗风险。     

Measuring the relationship between employees' health risk factors and corporate pharmaceutical expenditures

This study demonstrates the relationship between self-reported health risk factors on a health risk appraisal and pharmaceutical expenditures for a large employer. A total of 3554 employees who were participants in a pharmacy benefit plan for the entire year of 2000 completed a health risk appraisal. As the number of self-reported health risk factors increased from zero to six or more, corporate pharmaceutical costs increased in a stepwise manner: US dollars 345, 443, 526, 567, 750, 754, and 1121 US dollars, respectively. After controlling for age, gender, and the number of self-reported diseases, each additional risk factor was associated with an average annual increase in pharmacy claims costs of 76 US dollars per employee. Specific health risks were associated with significantly higher expenditures. The results provide estimates of incremental expenditures associated with common, potentially modifiable risk factors. Pharmaceutical expenditures should be considered by corporations in their estimates of total health-related costs and in prioritizing disease management initiatives based on health risk appraisal data.     

Pharmaceuticals--cost or investment? An employer's perspective

Employers are becoming increasingly concerned about rising pharmaceutical costs. Are improved health and cost outcomes achieved as a result of increasing pharmaceutical costs? One should approach this issue with a holistic view that considers the overall impact that disease conditions have on health and productivity. To illustrate, we first identified the "top ten" most expensive physical and mental health concerns facing American businesses, using data from over 60 firms from the 1996 MarketScan Private Pay Fee-For-Service Research Database. For some of these top ten conditions, the literature already addresses the drug cost versus investment issue, with mixed results. For conditions in which uncertainty prevails and for other high-cost conditions, empirical analyses should address the drug cost versus investment issue to minimize the risk of a penny-wise and pound-foolish payment/coverage policy. A similar strategy should be applied to individual corporate diagnostic assessments.     

“When Diet and Exercise Are Not Enough”: An Examination of Lifestyle Change Inefficacy Claims in Direct-to-Consumer Advertising

Previous research suggests that direct-to-consumer (DTC) advertisements for pharmaceutical drugs have the potential to influence consumers’ perceptions of whether symptoms should be treated medically and/or through behavior change. However, the relative frequency of messages emphasizing these approaches in pharmaceutical advertising remains largely unknown. A content analysis of print and television advertisements for cholesterol management medication between 1994 and 2005 (for print) and between 1999 and 2007 (for television) was conducted. First, the extent to which established theoretical constructs drawn from health communication scholarship are depicted in the content of DTC cholesterol advertisements is quantified. Second, specific claims about behavior change inefficacy when a pharmaceutical alternative is available are identified. Findings indicate that DTC ads offer many mixed messages about the efficacy of diet and exercise in reducing cholesterol and risk of heart disease. Theoretical and practical implications of this work are discussed.     

Vulnerabilities to misinformation in online pharmaceutical marketing

Given the large percentage of Internet users who search for health information online, pharmaceutical companies have invested significantly in online marketing of their products. Although online pharmaceutical marketing can potentially benefit both physicians and patients, it can also harm these groups by misleading them. Indeed, some pharmaceutical companies have been guilty of undue influence, which has threatened public health and trust. We conducted a review of the available literature on online pharmaceutical marketing, undue influence and the psychology of decision-making, in order to identify factors that contribute to Internet users’ vulnerability to online pharmaceutical misinformation. We find five converging factors: Internet dependence, excessive trust in the veracity of online information, unawareness of pharmaceutical company influence, social isolation and detail fixation. As the Internet continues to change, it is important that regulators keep in mind not only misinformation that surrounds new web technologies and their contents, but also the factors that make Internet users vulnerable to misinformation in the first place. Psychological components are a critical, although often neglected, risk factor for Internet users becoming misinformed upon exposure to online pharmaceutical marketing. Awareness of these psychological factors may help Internet users attentively and safely navigate an evolving web terrain.     

5种感冒药的药物经济学及用药风险分析

运用药物经济学的方法对杭州市场上常用的5种感冒药的成本、效果及用药风险进行了分析,结果显示：E组（快克）成本最低,成本效果比最小;B组（白加黑）用药风险最小。     

Risk sharing arrangements for pharmaceuticals: potential considerations and recommendations for European payers

Background

There has been an increase in 'risk sharing' schemes for pharmaceuticals between healthcare institutions and pharmaceutical companies in Europe in recent years as an additional approach to provide continued comprehensive and equitable healthcare. There is though confusion surrounding the terminology as well as concerns with existing schemes.

Methods

Aliterature review was undertaken to identify existing schemes supplemented with additional internal documents or web-based references known to the authors. This was combined with the extensive knowledge of health authority personnel from 14 different countries and locations involved with these schemes.

Results and discussion

A large number of 'risk sharing' schemes with pharmaceuticals are in existence incorporating both financial-based models and performance-based/outcomes-based models. In view of this, a new logical definition is proposed. This is "risk sharing' schemes should be considered as agreements concluded by payers and pharmaceutical companies to diminish the impact on payers' budgets for new and existing schemes brought about by uncertainty and/or the need to work within finite budgets". There are a number of concerns with existing schemes. These include potentially high administration costs, lack of transparency, conflicts of interest, and whether health authorities will end up funding an appreciable proportion of a new drug's development costs. In addition, there is a paucity of published evaluations of existing schemes with pharmaceuticals.

Conclusion

We believe there are only a limited number of situations where 'risk sharing' schemes should be considered as well as factors that should be considered by payers in advance of implementation. This includes their objective, appropriateness, the availability of competent staff to fully evaluate proposed schemes as well as access to IT support. This also includes whether systematic evaluations have been built into proposed schemes.     

Effect of Japanese government policy on hospital pharmaceutical profit levels.

OBJECTIVES: Our main objective is to examine whether the Japanese government's pharmaceutical price reduction policy has reduced the size of pharmaceutical profit traditionally enjoyed by health care providers. We discuss alternative measures that the government could introduce in an attempt to control drug costs. METHODS: We review Japan's pharmaceutical reimbursement system. We then analyse published and unpublished data in an attempt to reach our main objective. Calculations are made from raw data, provided by the National Hospital Federation of Japan, in order to discover the extent to which hospitals are experiencing financial difficulties. RESULTS: Due to pharmaceutical product shifting by hospitals from older, less profitable drugs to newer, more profitable ones, drug profit margins may not have fallen to the extent that is often reported in the Japanese press. Furthermore, increased prescribing, possibly due to the ageing of the population, may have maintained the total drug profits of hospitals, to a large extent, despite any reduction in profit margins. CONCLUSIONS: Although drug price reduction policy has had some success in controlling pharmaceutical expenditure, there is little evidence to suggest that total pharmaceutical profits for the provider units have been seriously undermined, despite the prevalence of this notion among hospital administrators. Nevertheless, in order to promote the more efficient and effective manufacture and utilization of pharmaceuticals, the government should seriously consider alternative methods for controlling pharmaceutical costs.