谈判药品报销政策的满意度研究：以西安市为例-《中国卫生质量管理》

文章信息/Info

Keywords:: Negotiated Drugs; Medical Insurance Billing; Transition Period; Reimbursement Policy; Satisfaction; Service Quality

摘要:: 目的调查参保者和药店工作人员对西安市谈判药品挂账过渡期报销政策的知晓率与满意度，为医保谈判药品政策落地提供依据。方法对3家西安市特定药店工作人员及到店购买谈判药品的参保者进行问卷调查，对青岛市、成都市及西安市人社局相关人员、西安市药店相关人员及参保者进行访谈。结果参保者对西安市谈判药品挂账过渡期报销政策总体知晓率较低，药店工作人员总体知晓率较高；参保者和药店工作人员总体满意度都较高。被调查者对该政策不满意的方面主要是政策普及程度不够、需先垫付药品报销部分费用、报销程序繁琐等。结论相关部门应加强谈判药品相关政策宣传，加快出台特药定点药店管理办法，完善医保信息化系统等。

Abstract:: Objective To investigate the awareness rate and satisfaction degree of insured and pharmacy staff on the later reimbursement policy of negotiated drugs in transition period in Xi'an, providing evidence for the practice of negotiated drug policy.MethodsQuestionnaire survey was used to investigate pharmacy staff and insured at three medical insurance special medicine drugstores. Qualitative interview was used to interview relevant personnel of Human Resources and Social Security Bureau, relevant personnel of Pharmacy and insured persons in Qingdao city, Chengdu city and Xi'an city. ResultsThe overall awareness rate of insureds was low, the overall awareness rate of pharmacy staff was good. The overall satisfaction of insureds and pharmacy staff was good. The respondents' dissatisfaction with the policy was mainly due to insufficient policy popularization, residents needing to pay for the medical expenses in advance and complicated reimbursement procedures. Conclusion Relevant departments should strengthen publicity on negotiation of drug-related policies, speed up the introduction of the management measures of designated drugstores for special drugs, and improve the information system of medical insurance