Analysis of disease spectrum and drug consumption of field medical team in field training in summer / 中华急诊医学杂志

Objective:To analyze the common disease spectrum and medication of field medical team in our hospital in summer, and to provide medical and medicinal material supply for field medical team.Methods:The data of all cases of field medical team members during the training period were collected. The types and composition ratio of diseases were analyzed, the drug consumption was counted, and the drug use indicators were calculated including daily drug dose (DDDs), daily drug dose cost (DDDC), drug utilization rate (DUR) and drug ranking ratio (R).Results:During the 12 days of the field training in summer, 77 field medical team members had 91 medical visits and 117 cases of diseases, including 44 males and 33 females, with an average age of 39.7 years. There were 52 cases of respiratory diseases, 21 cases of digestive diseases, 18 cases of mosquito bites and skin diseases, 15 cases of trauma and skeletal muscle system diseases, 5 cases of ophthalmic diseases, 2 cases of neurological diseases, 2 cases of gynecological diseases, 1 case of oral diseases and 1 case of heat stroke. The top five drugs of DDDs and DUR were respiratory drugs, sensory organ drugs, dermatological drugs, antibiotic drugs, digestive system drugs and musculoskeletal system drugs.Conclusions:The disease composition and drug demand of field training in summer have certain characteristics. It is of great guiding significance to know the characteristics of disease incidence and drug consumption of field training for the medical support ability and training tasks for field medical teams in field training in summer.

Investigation on Synergistic Effect between Centralized Drug Quantity Purchase Policy and Medical Insurance Reimbursement System / 中国药房

OBJECTIVE：To investigate the synergistic effect and deficiencies between centralized drug quantity purchase policy and medical insurance reimbursement system ，and to provide feasible suggestion to further improve its synergistic effect. METHODS：The literature analysis method and policy evaluation method were adopted to expounds the direct and indirect synergistic effect between the current centralized drug quantity purchase policy and medical insurance reimbursement system in China，and analyze the existing problems so as to put forward the feasible suggestions. RESULTS & CONCLUSIONS ：The centralized drug quantity purchase policy had a direct impact on the payment mode of medical insurance reimbursement system in technical level ，performance evaluation in effect level and process control in management level. The indirect synergy included ： centralized drug quantity purchase policy could promote the adjustment of drug supply security system to adapt to the reform of medical insurance payment ；it could adjust the pharmaceutical market ，and affect the reform of medical insurance reimbursement system. The disadvantages were as follows ：the varieties of selected drugs was still narrow ，and there was room for further improvement in purchasing scope and medical insurance fee reduction ；“one-size-fits-all”payment standard for unselected drug might weaken pharmaceutical companies ’enthusiasm for generic drug research and development. Therefore ，the next step is to significantly expand the variety and scope of procurement ，and appropriately liberalize the medical insurance payment restrictions for drugs with fewer varieties ；coordinate medical insurance reimbursement policies and procurement programs ，and improve the rationality and perfection of medical insurance payment ；guide the medical institutions to change the concept from “price-based medical treatment ”to“value-based medical treatment ”，take into account the interests of all parties in the market ，so as to form a comprehensive coordination adjustment mechanism of drug price and medical insurance reimbursement system.

Novel Coronavirus Infection Response ：Prevention and Control Strategies Based on Drug ，Material Supply and Emergency Management / 中国药房

OBJECTIVE：To provide drug ，material supp ly and emergency management reference for novel coronavirus （SARS-CoV-2）infection in pharmacy staff in hospital. METHODS ：The method of 5M1E was used to analyze the six main factors，including man ，machine，material，method，environment and measurement of drug ，material supply and emergency management. The relevant prevention and control strategies were put forward. RESULTS & CONCLUSIONS ：In the drug ，material supply and emergency management of epidemic prevention and control ，the man factors were involved ，such as mainly pharmacists from pharmacy departments of medical institutions. At the same time ，the management also involved machine factors such as drug storage，cleaning and disinfection ；material factors such as emergency drugs ，disinfection products ，in vitro diagnostic reagents ， the guarantee of medicine materials for medical team ，investigational products ；methods factors such as relevant management measures；environmental factors such as storage environment and facilities ；measurement factors such as drug use ，drug and substance reserve. In view of the above factors ，it is suggested to strengthen the professional knowledge and communication skills training of pharmacists ，and strengthen humanistic care ，so as to improve their post competency ，communication in emergency response and psychological tolerance. Equipment and materials management shall be strengthened ，and equipment maintenance and disinfection shall be done well to ensure normal use of equipment. According to the evidence-based method ，the emergency drug list should be established. According to the disinfection protection requirements ，the disinfection products should be reasonably selected and their quality and sufficient inventory should be ensured. The qualified in vitro diagnostic reagents should be purchased in time. The investigational products should be managed reasonably according to the relevant requirements of clinical trials ，to ensure the drug and material supply of medical team members. Emergency plans and standard operating procedures shall be formulated，the principle of sympathetic drug use shall be followed ，and the management of off-label drug use and early warning of drug and material shortage shall be done well. Reasonable storage space should be reserved to strengthen environmental monitoring and disinfection. We should strengthen the monitoring and reporting of daily data ，strengthen the quality monitoring ， and accept the independent audit of the third party. Above strategies are helpful to improve the ability of drug supply risk identification and response ability ，and cooperate with the medical team to timely rescue patients.

Study on Multi-agent Information Interaction Mechanism of Drug Supply Emergency Management Based on Multi-agent Sy s- tem / 中国药房

OBJECTIVE： To provide reference for improving the efficiency of drug supply emergency management in China. METHODS： Referring to the general principle of multi-agent system， the multi-agent information interaction mechanism of drug supply emergency management was constructed by using drug production and distribution enterprises， medical institutions， government， patients and media as the main bodies. RESULTS & CONCLUSIONS： In this study， a multi-agent information interaction mechanism of drug supply emergency management was preliminarily established， which was composed of risk information transfer coordination mechanism， information sharing mechanism and emergency task decomposition mechanism. The process can be divided into four stages as risk prevention， risk early warning， risk response and risk mitigation. The multi-agent information interaction mechanism of drug supply emergency management had certain applicability to improve the transmission efficiency of key information in the process of drug supply emergency management， which can provide new ideas for relevant departments to improve the ability of drug supply risk identification and response， and then improve China’s drug information monitoring system and supply guarantee system.

Study on the Distribution ，Drug Supply and Quantity of Licensed Pharmacists in Retail Pharmacies around 5 Third Grade Class A Hospitals from Beijing / 中国药房

OBJECTIVE： To investigate the distribution， drug supply and quantity of licensed pharmacists in retail pharmacies around Third Grade Class A Hospitals， and to provide reference for decision-making of related management departments. METHODS： Field investigation and questionnaire survey were used to investigate the distribution， type， operating area， annual turnover， drug type， ranking of consumption sum， daily prescription amount and pharmacist allocation of 5 Third Grade Class A Hospitals in Beijing and general information of 100 surveyed pharmacists in 2017. RESULTS： There were 43 retail pharmacies in total within 1 km of 5 Third Grade Class A Hospitals， with an average of 8.60 retail pharmacies for each hospital. The number of retail pharmacies with distance between 200-400 m and 800-1 000 m was the largest （11）， of which 21 （48.84％） were chain drugstores. The operating area of 38 pharmacies （88.37％） was in the range of 100-175 m2， mainly ranging 100-125 m2 （16 pharmacies， 37.21％）. The annual turnover of 40 pharmacies were counted and ranged 50-10 000 ten thousand yuan， among which the pharmacies 0-200 m away from the hospital had the highest annual turnover. The average variety of drugs （prescription drugs and over-the-counter drugs） was 2 511 kinds. 34 pharmacies （79.07％） had more varieties of over-the-counter drugs than prescription drugs， and the consumption sum of over-the-counter drugs was higher than that of prescription drugs in 26 pharmacies （60.47％）. Top 3 drugs in the list of consumption sum were antineoplastic drugs， cardiovascular drugs and anti-infective drugs. Average daily prescriptions of 28 drugstores （65.11％） were less than 10 pieces； average daily prescription were more than 20 pieces in only 7 pharmacies （16.28％）. On average， each pharmacy had 7.4 staff members and 1.37 licensed pharmacists. 58 staff members’ first degree was junior college （58％）， 38 staff members’ first degree was technical secondary school or high school （38％）， and only 3 （3％） staff members’ first degree was undergraduates or above. CONCLUSIONS： With the gradual promotion of “health care policy” and the outflow of more hospital prescriptions， the retail pharmacies around hospitals should increase their numbers， expand the operating area， accelerate the construction of licensed pharmacists and improve the education level of pharmacists so as to improve the pharmaceutical care ability.

Analysis of the Reasons for Drug Shortage and Countermeasure Study in Medical Institutions of Sichuan Province from the Perspective of Manufacturers and Distribution Enterprises / 中国药房

OBJECTIVE： To investigate the reasons for drug shortage in medical institutions of Sichuan province and put forward relevant countermeasures， and to provide reference for establishing supply security mechanism of drug shortage. METHODS： Questionnaire survey was conducted to investigate drug shortage in 78 medical institutions of the province during Jan. 2015-Jun. 2017. Traceability investigation was conducted from manufacturers and distribution enterprises involved in drug shortage. Questionnaire survey and field investigation were combined to analyze the reasons for drug shortage in Sichuan province and put forward countermeasures. RESULTS： Totally 78 questionnaires were sent out to medical institutions with recovery rate and effective rate of 100％. A total of 206 drugs were reported by 78 medical institutions， involving 240 specifications for shortage in total. Totally 140 questionnaires and 68 questionnaires were distributed to the manufacturers and distribution enterprises involved in drug shortage， and the recovery rate and effective rate were all 100％. Combined with the field survey， survey results of shortage drugs of 212 specifications were obtained. From the perspective of manufacturers， the most important factors causing drug shortage were the increase of production cost （66.51％） and circulation cost（26.88％）. From the perspective of distribution enterprises，the main factors causing drug shortage were insufficient supply of drugs（75.47％），inventory management（16.51％） and price inversion（11.32％）. CONCLUSIONS： Main reasons of drug shortage from manufacturers and distribution enterprises include the increase of production cost and circulation cost， drug price inversion， inventory management and bidding procurement. It is suggested that measures should be taken to improve the bidding and pricing system of drugs， mobilize the enthusiasm of enterprises； improve the early warning mechanism of drug shortage on the enterprises， strengthen information communication； establish the mechanism of drug shortage reserve， organize the emergency production of drug for shortage； strengthen the management of drug shortage supply chain， purify the unhealthy atmosphere in the market； improve the emergency disposal methods of drug shortage， and improve the supply guarantee ability of drug shortage. Departments cooperate to reduce the emergence of drug shortage and ensure the continuous access to safe and effective drugs in clinic.

The current situation of the drug supply and determinants of drug shortage in primary health centers:A case study of Anhui Province / 中国卫生政策研究

Objective: To investigate the current situation of drug supply and determinants of drug shortage in primary health institutions in Anhui province. Methods:Primary health institutions in Anhui province were selected as the main research subjects. One hundred and six (106) primary health institutions from three areas/districts in Anhui province namely northern Anhui,Central Anhui,and Southern Anhui were selected with stratified random sampling as the first sample,and 54 pharmaceutical producing enterprises and 62 pharmaceutical trading enterprises were selected with convenience sampling method as the second sample. The survey was conducted by issuing questionnaires to record views of the respondents to help understand the current situation of drug supply from the first sample and the main de-terminants and solutions of drug shortage from two samples. Results:13% of the primary health institutions still suffer from serious shortage of drug supply; the drug distribution rate varies greatly between units, and 19% of the primary health institutions have a drug distribution rate below 70%,and all primary health institution within the scope of inves-tigation experienced drug shortages. The frequency of choices of determinants of drug shortage were in sequence of or-der:drug demand instability (19.20%), drugs have a new and higher profit alternative (15.94%), etc.; The fre-quency of choices of solutions of drug shortage of primary health institution were in sequence of order:to improve the national list of essential medicines(12.78%),appropriate improvement in efficacy the low-priced varieties(with cura-tive effect) (12.03%),etc. Conclusions:Primary health institutions suffer from drug shortage issue widely,and the reasons for the shortage of drugs are more complicated;the government should continue to implement relevant policies, comprehensively improving the primary health institution drug supply mechanisms in all to prevent drug shortages.

Study on the Stakeholders of Drug Supply Support Reform in Sanming City / 中国医院管理

Government departments,pharmaceutical enterprises,health providers and patients were the four main stakeholders who involved in drug supply support reform in Sanming City.The paper centered on stakeholders' role and basic appeal,their influence on the reform or the influence of reform on them and the probable problems of reform,to make the motivation and resistance of the reform clearly and provide evidence for the sustainability and reproducibility of the reform.

Policy analysis for drug supply support reform in Sanming / 中华医院管理杂志

The paper centered on the background,objectives,key actions of the policy and the relationships between policy objectives and key policy actions.Further analysis went on to the three phases of policy implementation and phased achievements,as well as the opportunities and challenges of the policy.These efforts aim at supporting sustainable development of the drug supply support model and hospital reform stage of greater risks and challenges with policy recommendations in Sanming city.

Exploration of New Pharmacy Management Model Based on VMI Model under New Medical Reform / 中国药房

OBJECTIVE:To investigate the new management model of the hospital pharmacy established by application of vender managed inventory (VMI) model. METHODS:Concerned about the implementation of VMI model,its effects and prob-lems,new management model of hospital pharmacy were described after the hospital cooperated with two suppliers. The hospital is mainly in charge of the management and application of pharmaceutical staff and equipment,drug capital flow,and the selection and optimization of drug use list;focus on the training of pharmaceutical talents;improve drug quality management,pharmaceuti-cal administration,pharmaceutical care and rational drug use. Two suppliers are mainly in charge of drug logistics,and the alloca-tion of servicer,software and hardware(as automatic medicine dispensing machine);share logistic cost of supply chain. Drug in-formation flow was established by both hospital and supplier. RESULTS:After cooperation,pharmaceutical staff,related equip-ment and inventory cost(floating capital decreased by 10 million yuan each month)were decreased,and the efficiency of distribu-tion improved;the error rate of drug dispensing in outpatient pharmacy were decreased (decreasing from 0.39‰ to 0.12‰) after the establishment of automatic pharmacy. The establishment of early warning system for abnormal patients flowrate in pharmacy window shortened the time of getting medicine,and improved service level and satisfactory degree of patients (increasing from 84.91% to 93.62%). CONCLUSIONS:New management model of hospital pharmacy based on VMI model provides reference for public hospital reform and hospital-enterprise cooperation under New Medical Reform.

STUDY RESULT OF DRUGS SUPPLY FOR PEPTIC ULCER / Монголын эм зүй, эм судлал

Introduction:Structure and Function of the digestive organ diseases in that commonly occurred Ulcer Disease (PUD) is becoming one of the major diseases in the population furthermore it is tending to increase and peptic ulcer malignity is in the fourth leading tumor which causes to death.80% of the patients who has Gastric ulcer, 80 % of the patient who has PUD, has helicobacter pylori infections.Mongolian statistics data estimates that there are in total 355256 structures and function of the digestive organ diseases were registered in 2011. 25.2 % of stationary disease, 74.8% of is ambulatory diseases from them stationary disease of PUD are 3.74 %, ambulatory disease of PUD are 4.84%.Purpose of the study: Indicate the substantial supply of essential drugs of PUD in the stationary and ambulatory treatment.The study material and method:Diagnosis of PUD 2010-2012, The retrospective study has been done on the history of 393 stationary patients in the Gastroenterlogy Department of Orkhon, Uvur-Khangai, Khovd, Dornod’s regional center for diagnosis and, State Central Clinical Hospital, Clinical Hospital-2, Hospital-3 named after Mr. Shastin, Hospitals in Songini Khairkhan District and Nalaikh Districtbut also 107 ambulatory patient’s substantial supply of prescribed drug treatments were compiled by cross sectional studies which is specifically developed study card.WHO advised the drug supply “ Managing drug supply, the selection, the procurement, distribution and use of pharmaceuticals ” method by Jonathan D. Quick, Jamas R. Rakin, Richard O.Laing, Ronald W.O’Connor, Hans V.Hogerzell, M.N.G.Dukes, Andrew and Кобзарь л.в, дрёмова н.Б, глембоцкая г.т мнушко з.н. Statistic was developed and implemented excel, SPSS16.0 programme.Result of the study: In the study 500 people wereabove 20 and average age is 48.36±14.44.As a tertiary Level hospital 27, As a secondary Level hospital 18,Regional Center for Diagnosis 21, ambulatory treatment 22 kinds of drugs were used in PUD’s treatment. Omeprazolum 380, Metronidazolum 242, Sylcoseryl 227 were used.163380.15 tugrug (Mongolian currency) budget is required for Stationary treatment of Peptic Ulcer Disease (PUD) but 987540.95tugrug budget is required for ambulatory treatment.Conclusion:As a tertiary Level hospital 27, As a secondary Level hospital 18 and Regional Center for Diagnosis used 21 kinds of drugs for PUD.22 kinds of tablets were used for Peptic Ulcer Disease in an ambulatoryAs the result of the study 163380.15 tugrug for PUD’s stationary treatment, 987540.95 are required for PUD’s ambulatory treatment.

Assessment on Effectiveness of Free Drug Supplied to Poverty Schizophrenics in Beijing Mentougou District / 中国康复理论与实践

@#Objective To assess the effectiveness of free distributing antipsychotics to the poverty schizophrenics.Methods 116 non-acute poverty schizophrenics were given free antipsychotics and their status were evaluated by Brief Psychiatric Rating Scale (BPRS) before and after administration of antipsychotics.Results The BPRS scores of schizophrenics decreased linearly with time （ P<0.05） during 4 months follow-up study.Conclusion Poverty schizophrenics acquire good therapeutic efficacy after accepting free antipsychotics, and the government should provide the poverty mental disorder patients with related policy and fund support.

Practice of Zero Inventory Principle Management Mode to Achieve Optimized Workflow in Hospital Drug Supply Storeroom / 中国药房

OBJECTIVE: To provide references for the practice of the zero inventory management mode in hospital drug supply storeroom.METHODS: The zero inventory management mode in hospital drug supply storeroom was summarized based on experiences of hospital drug supply storeroom management in our hospital.RESULTS & CONCLUSIONS: After introduction of zero inventory management principle in hospital drug supply storeroom,the drug turnover frequency in our hospital reached 8～9 times every quarter,which has greatly lowered drug storage costs,activated the working capital,and brought down the proportion of drug fund to as low as about 15% of total hospital working capital.Therefore,establishing a reasonable managing mode suitable to hospital condition and applying zero inventory principle in the management of hospital drug supply storeroom are of importance for lowering hospital running cots and enhancing working efficiency.

Emergency Drug Supply and Pharmaceutical Support in Case of Emergent Events / 中国药房

OBJECTIVE:To provide reference for the hospitals about emergency drug supply and pharmaceutical support in case of emergent events.METHODS:The pertinent literature both at home and abroad was retrieved and summarized analytically.RESULTS:The definition and the classification of emergent events were introduced,and the emergency drug supply and pharmaceutical support both at home and abroad in case of emergent event were introduced.CONCLUSIONS:Drugs are essential thing in medical aid in case of emergent events,and medical institutions should establish a scientific and practical drug supply system,and the pharmacists should bring their professional talents into full play by participating in medical aid in case of emergent event to ensure safe,effective and economic drug use.

Hospital Drug Supply to Meet Radiation Accident / 中国药房

OBJECTIVE: To explore a drug supply system to meet radiation accident.METHODS: According to the characteristics of drug utilization for radiation disease,a retrospective analysis was conducted on the drug demand and supply in the course of treating two patients with severe radiation disease.RESULTS: The characteristics of drug supply to meet demand of remedy of acute radiation sickness manifested as a great variety and wide scope of drugs involved and purchase without scheme because of uncertainties of dosages and course of treatment,and the time is urgent,and the drug supply is more difficult.Great importance should be attached to the reserving of drugs,information,capability,and pre-draft in building and operating the drug supply system to meet radiation accident.CONCLUSION: To build a drug supply system to meet radiation accident,reasonable organization and utilization of drugs resources is quite necessary.

Development and Research of Personnel Resources of Licensed Pharmacist of Drug Supply Enterprises in China / 中国药房

OBJECTIVE:To study the current situation of development in personnel resources of licensed pharmacists of drug supply enterprises in China and the ways of development.METHODS:The existing problems in the development of per-sonnel resources of licensed pharmacists were analyzed through the ways of questionnaires and interviews.RESULTS&CONCLUSIONS:The drug supply enterprises lacked collocation and application rules of pharmacists and there lacked a system for employing,training,assessing and encouraging the licensed pharmacists.Furthermore,because of the inefficient policy,the supply-demand market of licensed pharmacists was unsatisfactory and the functions of the pharmacists were incomplete.Therefore,the practicing environment for the licensed pharmacists must be optimized.It is recommended that a perfect system of employment and assessment should be established;the full-time practice and the part-time practice should be allowed to coexist;the information network platform for supply-demand of the licensed pharmacists should be set up to improve the management as well as self-discipline function of licensed pharmacist association,better the further education system,and therefore promote the development of personnel resoures.

Investigation and Research on GSP Authentication of Drug Supply Enterprises in Shannxi Province / 中国药房

OBJECTIVE:To find an efficient avenue to the solution of problems existed in GSP authentication so as to provide references for the concerned governmental departments in the process of working out further laws and regulations and policies.METHODS:Practical problems existed in the GSP authentication of drug supply enterprises in Shannxi province were analyzed by the on the spot research method.RESULTS&CONCLUSION:Only through multi-sectional cooperation,further improving personnel quality of different kinds of people,clarifying each one's duty and regulating different management sys-tem,can GSP be put into practice successfully.

Enforcement of Six Sigma in Drug Supply Management in Our Hospital / 中国药房

OBJECTIVE:To improve the management on drug supply in our hospital by using the Six sigma method. METHODS: The quality control of the management on drug supply is achieved by practicing the five steps of Six sigma: concept, measurement, analysis, improvement and control. RESULTS & CONCLUSIONS: Six sigma method did effectively bring down the defect rate of drug supply from 6.66% before the introduction of the method to 0.59% after and raise the degree of satisfaction to the work of medicine provision from 80% before the introduction of the method to 95% after.

Significance of Customers' Demand-Driven in the Management of Drug Supply Chain / 中国药房

OBJECTIVE:To facilitate a high performance operation of drug supply chain so as to provide satisfactory service for patients,the common terminal customers.METHODS:The principle of customer demand driven in drug supply chain and the significance of customer demand driven in drug supply chain management as well as the role hospitals played in the practice of the customer demand driven-based drug supply chain management were analyzed and qualitatively described.RESULTS & CONCLUSIONS:In the environment of buyers' market of drugs,as the terminal customers' envoy plenipotentiary and the best valuable clients in the drug market,hospitals play a key role in back driving drug supply chain's high performance operation.

Proposals for Information System of Drug Distribution Based on Design and Application of Drug Supply Chain Management System / 中国药房

OBJECTIVE:To design and apply drug purchase and distribution information system.METHODS:Using JA?VA,SOAP and MIDAS technology based on internet and intranet network,we developed drug supply chain management system by Oracle9i database and delphi7kit.RESULTS:The system including medical electronic commerce platform,digital drug stock and standard data interface software were developed.Proposals for information system of drug distribution was also introduced.CONCLUSION:Extensive application of the system will bring about notable economic as well as social profits.