军队人员用药消费的影响因素

目的：探讨军队人员用药消费的影响因素。方法：运用定性与定量相结合的方法。通过对46所驻军以上医院军队人员用药消费资料的分析,建立了用药消费影响因素指标体系;应用计量经济学研究方法,对多因素进行筛选。结果：医院级别,用药范围,军人平均住院日、药品价格及平均处方药品费用是影响军队人员用药费用的主要因素。结论：我军应加强药品费用研究,进一步提高卫生经费的保障效能。     

军队老干部医院门诊用药现状调查

对军队医院门诊老干部用药现状调查结果提示：①用药品种广、数量多、人均药品费用较高、高消费人员占少数、单纯取药现象较普遍；②根据用药和人均用药费用的前30位药品品种顺位情况分析，药品品种消费较集中，一些基本用药也在医院领取，其用药规律主要是取决于疾病种类。③对加强 医院与基层就医管理、特需用药管理、合理用药管理以及拨款方式进行了探讨。     

军队医疗保障制度改革前后伤病员用药情况分析

目的：了解医改实施后军队伤病员门诊和住院用药情况，探索存在问题及解决方法。方法：借助“军卫一号”数据库，调取医改前后军队各类保障对象用药信息，采用Microsoft Excel2003和SPSS11．0软件对统计结果进行汇总、分析和比较。结果：门诊人次均药品费用增幅为319．9％；住院人次均药品费用增幅为143．1％；床日均药品费用增幅为130．9％，各类人员门诊及住院药品费用均有不同程度的提升。结论：军队人员医疗保障制度改革后门诊及住院用药受益明显；各类人员用药水平显著提高；药品费用增长速度快的原因需进一步探讨；合理的药品消费机制急需建立。     

军队医院聘用人员现状及对策

在军队精减整编背景下,聘用人员日益成为军队医院发展的一支重要力量。本文从医院实践出发,对聘用人员现状展开调查、对聘用人员招录实践进行总结、对聘用人员人力资源管理进行思考。     

军队医改对医院医疗保障的影响及成效分析

目的：探讨军队医疗保障制度改革对军队人员医疗保障的影响，分析其成效。方法：采用统计资料汇总分析方法，对比分析某医院军队医疗保障制度改革前后军队各类人员门急诊、住院人次及医疗费用的变化情况。结果：①医改后军队人员门急诊就诊量下降，但军队人员门急诊总医疗消耗增多。②医改后军队人员住院总人次当年有所下降，次年便呈现增加趋势，军队人员住院总费用增加，但职工、家属住院费用下降。结论：军队分类保障模式已初步形成，合理医疗体系也已基本构建，统定管理制度逐步得到了落实，持卡就医全面展开，军队医改提高了军队人员医疗保障水平，给军队人员带来了方便。同时，军队医改起步初期某些方面尚需完善，作者提出了相应的改进建议。     

军队医改人员门急诊用药分析

为了更好地推行军队医改，落实《军队合理医疗用药范围管理办法》和卫生部、国家中医药管理局的《处方管理办法（试行）》，促进合理用药、规范用药，提高处方质量，确保用药安全，本文对门急诊处方进行了调查分析，现报告如下。     

军队医院聘用人员管理对策

通过对军队医院聘用人员的管理机制、考核机制、激励机制等问题分析,探讨加强和规范聘用制人员队伍建设,激发聘用人员工作热情和创新力,实现医院建设向依托军队资源和社会资源相结合的转变,促进军队医院的快速、持续和多维化发展。     

军队患者门诊信息的分析与利用

目的：了解军队人员门诊概况，探讨门诊用药、门诊质量的评价方法，辅助门诊管理。方法：借助统计分析方法和计算机软机系统，实现门诊信息分析系统，及时总结门诊用药、费用消耗、体系单位就医状况。结果：通过对某些身份人员一年门诊就诊情况分析发现，各体系单位保障水平较高；高消耗药品较集中，消耗前10位药品占总消耗的30％。结论：非治疗性用药和常规用药可分流到体系单位的门诊部，减轻医院门诊压力；门诊诊断信息缺失使门诊治疗质量和效果难以评价。     

军队医院聘用制卫生专业技术人员招聘与管理探讨

军队医院聘用卫生专业技术人员是指符合国家、军队规定的卫生专业技术岗位所需条件,由社会聘用到军队医疗机构的医、药、护、技、工程、研究岗位工作的合同制非军队人员。军队医院对社会人力资源的需求日见突出,其招聘及管理工作应依据国家、军队有关法规,维护受聘人员和聘任单位双方的合法权益,坚持按需设岗、择优聘用、同岗同酬和规范化管理。     

关于《军队医疗保障制度改革方案》的说明

为适应军队现代化建设和后勤保障改革的新形势,解决军队现行医疗保障制度存在的主要矛盾和问题,进一步提高军队人员的医疗服务质量和保障水平,经中央军委批准,颁发了《军队医疗保障制度改革方案》(以下简称医改方案)。现将有关情况说明如下：     

军队医院聘用人员流失原因调查

目的了解军队医院聘用人才队伍的流失现状。方法采用问卷调查法对三家部队综合性三级甲等医院3年的人员稳定性情况进行调查,做统计学分析。结果第一,按专业类别分析,医技专业流失率最高,其次是护理专业,且流失率呈逐年上升趋势,再次是医疗、药学专业;第二,按学历结构分析,研究生流失率最高;第三,按工作年限分析,工作3年以下的人员是稳定性最差的群体,流失率呈逐年上升趋势;第四,按离职原因分析,被国家、事业单位录用是离职的首要原因,其次是职业压力和家庭因素。结论聘用人才队伍的不稳定已成为制约军队医院发展的关键问题,必须采取有效的对策和措施,运用科学合理的人才管理机制和措施以最大限度地使用好各类人才资源。     

Pharmaceutical expenditure in Spain: cost and control.

In recent years, the Spanish government has been battling to keep pharmaceutical expenditures under control. Its measures include control of prices, introduction of a "negative list" of drugs no longer reimbursed, increased cost-sharing, and introduction of overall budgets for pharmaceutical expenditures. Although the average prices of old pharmaceutical products declined by 39 percent over the last 15 years and consumption in value increased by only 10 percent, real pharmaceutical expenditures in Spain increased by 264 percent over that period. The main reason for the continuing rise in these expenditures and the failure of cost-containment measures is the introduction of new, more expensive drugs, which often fail to offer any real therapeutic advantages over products already on the market. This situation is exacerbated by a lack of effective demand-side measures such as budgets for doctors and lack of a generics market.     

Drug consumption and health equity in the Metropolitan Area of Buenos Aires, Argentina]

OBJECTIVE: To assess the level of equity in drug consumption patterns in the Metropolitan Area of Buenos Aires, Argentina, given the transformation of the Argentine pharmaceutical market since the deregulation of the country's economy in 1991. Methodology: For this study, data from secondary statistical sources were processed and analyzed. The secondary sources used were two household surveys that contained a module on the utilization of health services and the associated expenditures. The surveys had been designed by the Ministry of Health and were applied in the Metropolitan Area of Buenos Aires in 1989 and 1995. RESULTS: There was a socially regressive increase in out-of-pocket expenditures on drugs between 1989 and 1995, in a market where average drug prices doubled in the midst of relaxed price controls and more open imports. The regressive character of drug expenditures was shown in the growth in direct spending for drug purchases, the increase in the proportion of private health expenditures devoted to drugs, and the unequal increase among the different economic strata in the proportion of family income going toward drugs. CONCLUSIONS: Out-of-pocket expenditures on drugs are an efficient indicator of equity for studying the financial protections that urban Argentines have when they become ill. This kind of indicator of financial equity could help improve the regulatory framework of the pharmaceutical market by incorporating social evaluation criteria along with analyses of pharmaceutical safety and therapeutic efficacy.     

DRGs支付制度在军队医院中的应用

本文分析当前军队医院按项目付费制度存在的问题,提出军队医院在持续发展中应接受DRGs这种新的支付制度,从根本上解决医疗费上涨、医患矛盾等问题,带动社会效益、军事效益和经济效益的提升,履行我军新时期的使命任务。     

从国际视角看我国的药品定价、补偿和可及性问题

随着药品费用的快速增长,药品政策在我国显得愈发重要。药品政策出台的目的是有效控制药品费用,而截至目前为止,这些政策的实施效果仍不尽如人意。通过比较研究的方法,对我国药品定价、补偿和可及性等问题提出一些政策建议。这些建议不仅是针对药品费用问题,更多的是针对正在不断增长的卫生费用问题。     

军队药学勤务再定义

目前，对军队药学勤务尚无明确定义，一般来说是指军队药学业务工作，其首要任务是策划、贮存、供应军队为完成战伤救治、疾病防治、防疫保健等任务所需要的药品、医疗器械和卫生材料。军队药材供应管理学就是我军研究药材供应的学科。本文通过对美军平战时药学勤务改革的分析，提出我军药学勤务定义是为完成军队战伤救治、疾病防治、防疫保健等任务所提供的药学服务，并明确了药学勤务今后的发展方向。     

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.     

法国药品定价及其补偿机制对我国的启示

对法国的药品定价方法和药品费用偿付政策进行介绍,阐述了与之相关的公共药品支出控制措施,提出了对我国药品定价与补偿政策调整及药品费用控制等方面的一些启示。