间断时间序列模型分析中国基本医疗保险药品目录调整对药物利用的影响

doi:10.5246/jcps.2015.11.096

中国药学(英文版) ›› 2015, Vol. 24 ›› Issue (11): 754-763.DOI: 10.5246/jcps.2015.11.096

间断时间序列模型分析中国基本医疗保险药品目录调整对药物利用的影响

翁庚¹, 马莉莉¹, 刘伊¹, 管晓东¹, 史录文^1,2*

1. 北京大学医学部药学院药事管理与临床药学系, 北京 100191
2. 北京大学医学管理国际研究中心, 北京 100191

收稿日期:2015-05-17 修回日期:2015-07-15 出版日期:2015-11-20 发布日期:2015-08-10
通讯作者: Tel.: 86-10-82805019, E-mail: Shilu@bjmu.edu.cn

Impacts of National Basic Medical Insurance Drug List adjustment on drug utilization in China: an interrupted time series study

Geng Weng¹, Lili Ma¹, Yi Liu¹, Xiaodong Guan¹, Luwen Shi^1,2*

1. Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University Health Science Center, Beijing 100191, China
2. International Research Center of Medical Administration, Peking University Health Science Center, Beijing 100191, China

Received:2015-05-17 Revised:2015-07-15 Online:2015-11-20 Published:2015-08-10
Contact: Tel.: 86-10-82805019, E-mail: Shilu@bjmu.edu.cn

摘要/Abstract

摘要：

本文旨在中国医药卫生体制下, 探讨医疗保险药品目录调整对药物利用的影响。我们采用间断时间序列模型, 分析2009版医保药品目录调整前后相关药品使用情况的变化, 发现2009年医保药品目录调整前后, 调整药品综合使用金额及每万人使用金额变化如下: 1) 原甲类调整到乙类的药品分别下降了13.87%和16.37%, 原甲类调整到自费的药品分别下降了38.74%和48.03%; 2) 原乙类调整到甲类的药品分别上升了74.12%和94.52%, 原乙类调整到自费的药品分别下降了19.79%和14.52%; 3) 原自费调整到甲类的药品下降了31.77%和36.22%, 原自费调整到乙类的药品下降了12.42%和22.05%。经研究发现中国基本医疗保险药品目录调整总体降低了药品使用金额。

关键词: 医疗保险, 药品目录, 药物利用, 间断时间序列

Abstract:

Under Chinese medicine and health care system, Medicine Catalogue for National Basic Medical Insurance (2009) was issued in 2009 in China to fulfill the basic drug demands of the insured Chinese and to control the medical expenses. In this study, the influence of the list adjustment on drug utilization was investigated. With the comparison between inpatients’ use of drugs before and after adjustment of Basic Medical Insurance Drug List, we classified the drugs adjusted in national list into six categories: class A to class B, class B to class A, class A to class C, class B to class C, class C to class A, and class C to class B (class A referring to overall insured drugs, class B referring to partial reimbursement drugs, class C referring to self-funded drugs in China), and drug utilization and expenditure were analyzed with time series model. We analyzed the overall expenditure and average expenditure per 10 000 people based on the comparison before and after the adjustment of 2009 Basic Medical Insurance Drug List. The drug expenditure from class A to class B was decreased by 13.87% of overall expenditure and 16.37% of average expenditure per 10 000 people, and it was decreased by 38.74% and 48.03% from class A to class C; respectively, the drug expenditure from class B to class A was increased by 74.12% and 94.52%, while it was reduced by 19.79% and 14.52% from class B to class C; expenditure declined by 31.77% and 36.22% from class C to class A, and expenditure was increased by 12.42% and 22.05% from class C to class B, respectively, both were lower than before. The adjustment of National Basic Medical Insurance Drug List reduced the overall drug expenditure.

Key words: Medical insurance, Drug list, Drug utilization, Interrupted time series

中图分类号:

R951

Supporting:

翁庚, 马莉莉, 刘伊, 管晓东, 史录文. 间断时间序列模型分析中国基本医疗保险药品目录调整对药物利用的影响[J]. 中国药学(英文版), 2015, 24(11): 754-763.

Geng Weng, Lili Ma, Yi Liu, Xiaodong Guan, Luwen Shi. Impacts of National Basic Medical Insurance Drug List adjustment on drug utilization in China: an interrupted time series study[J]. Journal of Chinese Pharmaceutical Sciences, 2015, 24(11): 754-763.

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间断时间序列模型分析中国基本医疗保险药品目录调整对药物利用的影响

Impacts of National Basic Medical Insurance Drug List adjustment on drug utilization in China: an interrupted time series study

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