目的: 分析第一批国采药品在中医医院的执行情况,并调查患者对门诊药房的满意度,推动国采政策完善和医院服务水平提升。方法: 通过查阅文献和咨询专家的方式,探索构建国采药品在中医医院执行效果的评价指标体系。利用Excel 2013及Spss Statistics 25.0等软件对收集到的指标数据进行清洗整理,采用方差分析、秩和检验等统计学手段,对政策实施前后数据进行差异性、变化趋势等方面的分析。结果: 国采政策实施后,通过一致性评价的仿制药种数占比、门诊患者基本药物使用率、仿制药数量替代率、仿制药金额替代率和配送率共5个指标出现增长,共10个指标呈下降趋势。门诊药房满意度调查结果显示,门诊药房满意总得分为（39.35±0.84）分,满意度为87.45%;不同患病类型组间得分差异有统计学意义,慢性病患者的满意得分高于其他疾病类型,为（39.88±0.75）分。结论: 国采政策在样本医院的执行情况良好,既推动了医院药品目录的优化,又展现出对药品费用的管理效果,但也存在药品使用监管力度不足、政策之间缺乏衔接机制和部分项目服务水平不高的问题。建议医疗机构建立健全品种监管机制,以国采品种为中心,动态监测中标品种与可替代品种的使用情况,加强用药监测,同时加大政策宣传和人员培训力度,提高门诊服务水平,推进药品可及。建议相关部门建立健全政策衔接机制,分析研究政策之间的衔接与过渡,逐步解决因政策交互所产生的执行困难等问题。建议卫生部门加强对药品供应厂商的约束,医疗机构探索建立中西药结合的药品供应保障体系,合力保障药品供应。

Objective: The paper analyzes the implementation of the first batch of national centralized procurement drugs in TCM hospitals and investigates patients' satisfaction with outpatient pharmacies, so as to promote the improvement of national centralized drug procurement policy and hospital service level. Methods: By consulting literature and experts, the evaluation index system of the implementation effect of national centralized procurement drugs on TCM hospitals was established. Excel 2013, Spss Statistics 25.0 and other software were used to clean and organize the collected indicator data, and statistical methods such as the variance analysis and Chi-square test was used to analyze the differences and trends of the data before and after the implementation of the policy. Results: After the implementation of the policy of centralized drug procurement organized by the state, 5 indicators showed an increase, including the proportion of generic drug species that passed the quality and efficacy consistency evaluation, the utilization rate of essential drugs in outpatients, the substitution rate of generic drug quantity, the substitution rate of generic drug amount and the distribution rate, while a total of 10 indicators showed a downward trend. The satisfaction survey results of outpatient pharmacies showed that the total satisfaction score of outpatient pharmacies is (39.35 ± 0.84) points, with a satisfaction rate of 87.45%. There is a statistically significant difference in scores between different disease types, with chronic disease patients having a higher satisfaction score (39.88 ± 0.75) than other disease types. Conclusion: The implementation of the national centralized drug procurement policy in the sample hospital is good, which not only promotes the optimization of the hospital's drug catalogue, but also controls the drug costs. However, there are also problems such as insufficient supervision of drug use, lack of cohesion mechanism between policies, and low service quality of some projects. It is recommended that medical institutions establish and improve a supervision mechanism of drug species centering on the centralized procurement of drugs organized by the state, dynamically monitor the use of the bidding varieties and alternative varieties, strengthen drug monitoring, increase policy publicity and personnel training, improve outpatient service level, and promote drug accessibility. Secondly, it is recommended that relevant departments establish and improve the policy cohesion mechanism, analyze and study the cohesion and transition between policies, and gradually solve the difficulties in implementation caused by policy interaction. Finally, it is recommended that health authorities strengthen the constraints on drug suppliers, and medical institutions establish a drug supply guarantee system that combines traditional Chinese and western medicine to ensure drug supply.