辽宁省医疗机构2009年度药品采购和使用情况调查

2009年,我国全面推行政府主导、以省为单位药品集中采购制度,通过选取辽宁省5个地区、5个级别的45个医疗机构对2009年药品采购价格进行调查,发现了不同级别医疗机构药品采购价格和使用情况存在较大差异,而不同地区药品价格和使用情况无显著差异,根据调查结果提出建议,希望对药品集中采购政策的改革和完善有一定的启示。     

关于我国药品价格管制的相关思考

药品价格一直是人们生活中关注的热点话题。由于药品自身的特殊性,药品价格的形成受多种因素影响,更关系到广大人民群众的生命安全和健康水平。今年是改革之年,价格改革提速,药价改革在列,我国在推进药品价格市场化改革的同时,更应以一种新思路和视角对我国药品价格进行管制。本文从药品价格形成机制、生产流通环节、招标采购机制,监督体制,分析我国药品价格管制中存在的主要问题,为完善药品价格管制提出合理化建议。     

浅析指导用药的过程中常见的问题分析

随着社会的不断进步,人们对医疗的质量要求越来越高,但在指导用药的过程中存在问题,目前看病的以老年人居多,大部分老年人文化水平低,看不懂药品说明书的专业术语,就是知道用药的过程中存在许多问题,需要医疗人员对其进行仔细解释。医疗工作者要坚持以人为本,提高自身的专业素质,以病人为中心,提高自身的服务水平,从而提高整个医疗机构的服务水平。本文对病人用药的常见问题和怎样正确指导病人用药进行了分析。     

药品供给侧结构性改革破解药价虚高的思考

当前药价虚高是医药领域乱象的根本原因已成为不争的事实。虚高药价不但为人民群众深恶痛绝,成为看病难、看病贵的重要原因,而且已成为阻碍深化卫生改革的桎梏。因此,必须要痛下决心着力解决。文章通过分析药价虚高的现状、药价虚高的成因、药价虚高的危害,提出了基本用药由国家专营的药品供给侧结构性改革的对策,从而破解药价虚高的顽疾。

     

“以药养医”的根源分析与破除对策

通过对“以药养医”的分析认为：医疗服务价格体系不合理是“以药养医”的根源,“药价虚高”和医疗服务价格低于成本必然导致“以药养医”,而要破解“以药养医”必须同时切断医生账面收入和灰色收入与买药之间的关系。在此基础上,研究提出了放开药品定价和招标垄断、根据成本全面调整医疗服务价格、合理确定医务人员收入与社平工资倍数关系等3个方面的具体措施。     

当前农村药品市场存在的问题及监管对策初探

峄城区总人口37.3万,其中农村人口约占80%。目前有各类药品(医疗器械)生产经营使用单位268家,其中医疗机构(含村卫生室、诊所)125家,但大多集中在城区或镇街驻地。他们这种医药经销网点是百姓采购药品的重点场所,在某些偏辟山村几乎是唯一渠道。通过近一个时期的调整,我区的药品市场已日趋规范,但仍存在诸多问题,尤其是农村卫生部门的药品销售和疾病诊断中蕴含着很多的问题,急需尽快加以规范。     

我国医药购销领域商业贿赂行为的博弈论分析

中国医药行业药品销售领域的贿赂存在的事实。本文章通过博弈论模型分析行业贿赂形成的原因,分析医药分家的利弊,对近年来医药购销领域中发生的商业贿赂犯罪案件的发案特点和现因进行深一步分析,为深层次防治我国医药行业的购销领域的商业贿赂提供建议。     

基本药物制度实施与乡镇卫生院补偿机制转变

目的 了解乡镇卫生院各项收支及药品补偿状况,探讨基本药物制度实施后,取消药品加成对乡镇卫生院的影响。方法 收集华东三省49家乡镇卫生院财务及药品收支数据,对定量资料进行统计分析。结果 乡镇卫生院主要的补偿渠道依然是药品收入,乡镇卫生院收入增长主要归因于增加药品收入。在财政补助收入大幅增加的情况下,乡镇卫生院对药品收入的依赖程度有所降低。结论 基本药物制度的实施对乡镇卫生院的平稳运行有影响,可采取加强财政补助、建立综合补偿机制、遏制药品价格虚高等措施保证乡镇卫生院在改革中的平稳运行。     

药品质量管理探析

药品质量与医疗质量及病人用药安全有着直接关系,药品质量管理也是保证医疗效果的前提,我国在药品质量管理的过程中目前存在着漏洞和安全隐患。笔者就目前药品质量管理中存在的问题进行探讨,希望能对药品质量管理有所帮助。     

Investigation of the mechanism of temperature sensitivity of the electroreceptors of ampullae of lorenzini

In experiments on Black Sea skates (Raja clavata), the potential of the receptor epithelium of the ampullae of Lorenzini and spike activity of single nerve fibers connected to them were investigated during electrical and temperature stimulation. Usually the potential within the canal was between 0 and –2 mV, and the input resistance of the ampulla 250–400 k. Heating of the region of the receptor epithelium was accompanied by a negative wave of potential, an increase in input resistance, and inhibition of spike activity. With worsening of the animal's condition the transepithelial potential became positive (up to +10 mV) but the input resistance of the ampulla during stimulation with a positive current was nonlinear in some cases: a regenerative spike of positive polarity appeared in the channel. During heating, the spike response was sometimes reversed in sign. It is suggested that fluctuations of the transepithelial potential and spike responses to temperature stimulation reflect changes in the potential difference on the basal membrane of the receptor cells, which is described by a relationship of the Nernst's or Goldman's equation type.I. P. Pavlov Institute of Physiology, Academy of Sciences of the USSR, Leningrad. I. M. Sechenov, Institute of Evolutionary Physiology and Biochemistry, Academy of Sciences of the USSR, Leningrad. Pacific Institute of Oceanology, Far Eastern Scientific Center, Academy of Sciences of the USSR, Vladivostok. Translated from Neirofiziologiya, Vol. 12, No. 1, pp. 67–74, January–February, 1980.     

Principles of organization and evolution of systems of regulation of functions

Evolution of living organisms is closely connected with evolution of structure of the system of regulations and its mechanisms. The functional ground of regulations is chemical signalization. As early as in unicellular organisms there is a set of signal mechanisms providing their life activity and orientation in space and time. Subsequent evolution of ways of chemical signalization followed the way of development of delivery pathways of chemical signal and development of mechanisms of its regulation. The mechanism of chemical regulation of the signal interaction is discussed by the example of the specialized system of transduction of signal from neuron to neuron, of effect of hormone on the epithelial cell and modulation of this effect. These mechanisms are considered as the most important ways of the fine and precise adaptation of chemical signalization underlying functioning of physiological systems and organs of the living organism