Page 7 - 《中国药房》2022年10期

·药事管理·

基于熵值-聚类法的我国药品综合控费效果评价 Δ

沈月月 ，柳鹏程 ，罗雪燕 ，齐敏友 ，袁 泉 [1.浙江工业大学药学院，杭州 310014；2.中国药科大学国际医
1，4 #
1
3
1＊
2
药商学院，南京 211198；3.重庆第二师范学院生物与化学工程系，重庆 400067；4.重庆医药（集团）股份有限
公司，重庆 400010]
中图分类号 R95 文献标志码 A 文章编号 1001-0408（2022）10-1153-06
DOI 10.6039/j.issn.1001-0408.2022.10.01

摘 要 目的 全面评价我国药品综合控费的效果，为进一步提升控费效果提供参考。方法 运用熵值法从药价控制能力、药费控
制能力、患者负担能力3个维度建立药品控费效果综合评价指标体系，对2016－2020年我国31个省（自治区、直辖市）的药品控费
效果进行综合评价，并通过k均值聚类法对我国各省份的综合控费效果进行聚类分析。结果与结论 2016－2020年，我国31个省
份药品综合控费效果的综合得分合计值分别为 14.64、16.71、17.58、17.57、17.88。聚类分析结果与熵值法排名具有一定的相似
性。我国医药卫生体制改革政策在取得阶段性成效之后进入平稳期；31个省份的药品综合控费效果呈现阶梯式特征，沿海经济
发达地区和部分西部地区省份的综合控费效果较好，中部地区省份紧随其后，而东北三省效果较差；综合医改试点省份的控费效
果提升显著。建议在全国范围内推广综合医改试点地区的成功经验，进一步深化药品带量采购、医保药品价格谈判及按疾病诊断
相关分组/按病种分值付费等支付方式改革政策。
关键词 药品综合控费；效果评价；熵值法；聚类分析

Effect evaluation of comprehensive drug cost control in China based on the entropy method-cluster analysis
SHEN Yueyue ，LIU Pengcheng ，LUO Xueyan ，QI Minyou ，YUAN Quan （1. School of Pharmaceutical
1，4
1
3
1
2
Science， Zhejiang University of Technology， Hangzhou 310014， China； 2. School of International
Pharmaceutical Business，China Pharmaceutical University，Nanjing 211198，China；3. School of Biological
and Chemical Engineering，Chongqing University of Education，Chongqing 400067，China；4. Chongqing
Pharmaceutical（Group）Co.，Ltd.，Chongqing 400010，China）
ABSTRACT OBJECTIVE To evaluate the effects of comprehensive drug cost control in China，and to provide reference for
further improving the effects of cost control. METHODS Entropy method was used to establish a comprehensive evaluation index
system of the comprehensive drug cost control effect from the respective of drug price control ability，drug cost control ability and
patient affordability. The comprehensively evaluate the effects of drug cost control in 31 provinces （autonomous regions and
municipalities）during 2016-2020. The k-means cluster method was used to analyze the effects of comprehensive drug cost control
in various provinces. RESULTS & CONCLUSIONS During the period of 2016-2020，the total score of comprehensive drug cost
control effect of 31 provinces were 14.64，16.71，17.58，17.57，17.88，respectively. The results of cluster analysis were similar to
the ranking of entropy method. Medical and health system reform policy had entered a stable period after achieving phased results；
the effects of comprehensive drug cost control was characterized by regional steps in 31 provinces；the effects of comprehensive
drug cost control were better in developed coastal areas and some provinces and cities of western regions，followed by provinces
and cities in central China；however，comprehensive drug cost control in 3 provinces of northeast China showed poor effect. The
effects of comprehensive drug cost control in pilot cities of comprehensive medical reform were significantly improved. It is
suggested that the successful experience of pilot cities of comprehensive medical reform should be promoted nationwide，and
policies such as volume-based drug procurement， medical insurance drug price negotiation， and diagnosis-related groups/
diagnosis-intervention packet payment method reform should be further deepened.
KEYWORDS comprehensive drug cost control；effect evaluation；entropy method；cluster analysis

Δ 基金项目：重庆市教委科学技术研究项目（No.KJ1901535）；重 为有效控制医药费用不合理增长、减轻群众就医负
庆医科大学附属儿童医院儿童医疗保障创新研究示范基地项目（No. 担，我国在“十三五”期间推行了一系列医药卫生体制改
NCRCCHD-2019-HP-12）
革政策：在公立医院改革方面，全面取消各级各类公立
＊硕士研究生。研究方向：药事管理、医药政策。E-mail：syyue_
医院药品耗材加成，实行“零差率”销售，有效降低了患
016@163.com
[1]
# 通信作者：主任药师，硕士生导师，博士。研究方向：医药卫生 者次均费用 。在药品供应保障方面，积极推行药品采
政策。E-mail：cqmn-007@163.com 购“两票制”，优化药品流通环节，有效降低了药品成

中国药房 2022年第33卷第10期 China Pharmacy 2022 Vol. 33 No. 10 ·1153 ·