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OBJECTIVE To analyze the situation and causes of the shortage of drugs in centralized volume-based procurement， and to put forward countermeasures and suggestions for optimizing centralized procurement rules and improving the drug shortage supply guarantee system. METHODS The shortage data of the first five batches of centralized purchasing drugs during January 2019 and December 2021 were collected from the Shortage Database of Chinese medicine economic information； descriptive statistical analysis was performed for shortage frequency， varieties and reasons. RESULTS & CONCLUSIONS After the first five batches of centralized volumetric procurement policy landed， the frequency of drug shortage reported for selected specifications and selected enterprises increased significantly， mainly drug shortage of selected enterprises. The shortage of some varieties from selected enterprises in the short term was obvious， and most of them were commonly used clinical drugs. The occurrence of drug shortages was affected by various links such as the production， circulation and use， and the main reasons were shortage or monopoly of raw materials. In order to ensure the drugs supply， the government should scientifically assess the risk of production interruption of enterprises， further optimize centralized procurement rules， improve the reporting system for drug shortages， and attach importance to the supply of key drugs； in addition， hospitals should take a variety of measures within the scopes of policies to flexibly respond to drug shortages so as to avoid delaying the treatment of patients.
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Objective To analyze the impact of the declining balance rate in military hospitals during new healthcare reform.Methods A military medical expense model was established,the parameters of the model were changed and the impact of the declining balance rate was analyzed.Results and Conclusion Military hospitals have to face up to the negative influence caused by the declining balance rate,actively promote expenditure compensation mechanism reforms,increase funding,enhance supervision,and separate revenues from expenditures.
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OBJECTIVE:To construct the evaluation index system for the effects of rational drug use policy in the military hos-pital. METHODS:Based on methods like literature analysis,expert consultation,modified Delphi method,analytic hierarchy pro-cess(AHP),the evaluation index system was constructed and the weight of indicators was calculated. The feasibility of the index system was verified by experimental evaluation. Through comparing drug use level between military patients and local insurance for medical care,the effects of rational drug use policy were evaluated in military hospital. RESULTS & CONCLUSIONS:The index system includes 3 first-level indexes as rationality,accessibility,economics,10 second-level indexes and 20 third-level indexes. The results of the experimental evaluation in 176 military hospitals show that the economic indexes scoring rate is lower than the reasonable indexes and the availability indexes,and the difference value are 3.12%and 4.06%;the first-level indexes average scor-ing rate of divisional hospital is higher than that of regimental hospital,and the difference value is 21.6%. The index system solves the problems of false data,incomplete evaluation,inadequate check,improves informatization level of evaluation,and realizes long-term dynamic monitoring and remote evaluation.
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Objective To assess differences between the medicine treatment level of military inpatients in military hospi-tal in 2009 and 2011 ,provide references for reasonable adjustments of health policy in future .Methods Medicine treatment da-ta from acute simple appendicitis ,coronary heart disease ,chronic bronchitis and type 2 diabetes from 16 military hospitals were excavated and analyzed by statistical methods to provide a comparative study of the medicine treatment level in 2009 and 2011 . Results 3748 cases from 16 hospitals showed the significant difference in the level of the medicine treatment in 2009 and 2011 , such as medicine cost ,medicine varieties ,primary medicine costs ,hospital daily medication cost ,and the date in 2011 is higher than 2009 .Conclusion It was showed that the medicine treatment level in four common multiple diseases in the military in 2009 and 2011 was changed .A long-term stability mechanism should be established for the evaluation of military medicine sup-port level ,which could provide strong evidence for future medicine policy adjustment .
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OBJECTIVE:To know about the implementation and existing problems of current Reasonable Medicine List for Mil-itary(Medicine List for short)(2014 edition). METHODS:The data of field investigation were summarized and analyzed. Compar-ative analysis was made to the data of medicines used by military patients and local insured patients in the general hospitals,hospi-tals affiliated to the military medical university,central hospitals,authorities'clinics and cadre's sanitariums'clinics (a total of 20)of 4 military regions in Nanjing,Lanzhou,Chengdu and Shenyang before and after the modification of the Medicine List. RE-SULTS & CONCLUSIONS:After the modification of the Medicine List,all the above-mentioned medical institutions of the 4 mili-tary regions used more varieties of medicines as set forth in the Medicine List,where there was the highest average increase up to 12.2% in the varieties of the medicines used by central hospitals,and the lowest average increase of 4.8% in those by general hos-pitals. Central hospitals used the largest number of varieties of medicines as set forth in the Medicine List,accounting for 83.3% of all varieties in the Medicine List on average;followed by hospitals affiliated to the military medical university,accounting for 80.6% on average;and the cadre's sanitariums'clinics used a smaller number of varieties thereof,only accounting for 63.9%. For military inpatients and outpatients,the medicine expense per capita increased by 15.0% and 18.0% respectively,which was differ-ent from that for local insured patients in the same period. It is suggested that the implementation of the Medicine List should be monitored and evaluated on a regular basis pursuant to the survey,to provide a reference for future adjustment of the Medicine List.
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Objective To explore the application of a system dynamics(SD) model to military medical expenses in PLA hospitals.Methods According to relevant theories of SD, the study has selected some important variables and defined the primary function relations in order to establish a military medical expenses SD model.Results and Conclusion The SD model is suited to modeling the PLA medical expenses and can serve as a theoretical basis for the policy innovation of the PLA medical system.
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The book of 68W Advanced Field Craft was introduced in this paper .The characteristics of the teaching pro-gram and details of combat medic of the US Army were summarized .Some suggestions were raised about the development and training of field first-aid skills of the PLA .
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The evolution of paper-based documentation for tactical combat casualty care in the U .S.Armed Forces was introduced .The main content , the form filler and method , and the way the field medical card issued in 2009 and 2013 carried were compared .The trend and characteristics of paper-based documentation for tactical combat casualty care in the U.S.Armed Forces were summarized , which could offer references for the optimization of paper-based and electronic documentation for tactical combat casualty care in China′s troops.
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OBJECTIVE:To discuss the trend of hospital preparations in the future METHODS:The developing history of and the main factors influencing hospital preparations were analyzed by literature review RESULTS & CONCLUSION:The trend of hospital preparations depends on the role and task of the hospital pharmacy The development of hospital preparations may have three possibilities:being repealed;being reduced;and being maintained the current situation It is not optimistic for the future of hospital preparations from the view of hospital pharmacy
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OBJECTIVE:To propose the idea that the national essential drug system was improved with legislation method,for example revising Law for Medicine Management. METHODS:The requirement and feasibility of the legislation of national essential drugs were analyzed. RESULTS&CONCLUSIONS:The improvement of the national essential drugs system by legislation means is the demands of guaranteeing public rights for drug use,the inner requirements of implementing national health policy and the basic reflection of legislating law for medicine management. The feasibility of essential drugs legislation was improved by absorbing foreign advance experience with current essential drug policy as base. The conception and management category of essential drugs system was defined clearly based on the amendment of Law for Medicine Management,which could be the legal footing of the formulation and implementation of the supporting policies for essential drugs system.