中国药房2024，Vol.35Issue(14)：1683-1689,7.DOI:10.6039/j.issn.1001-0408.2024.14.02
我国医保谈判药品落地问题的多重制度逻辑分析与政策建议
Multiple institutional logics analysis and policy suggestions on the use of national medical insurance negotiation drugs
摘要
Abstract
OBJECTIVE To clarify the institutional logics of the dilemma of the use of national medical insurance negotiation drugs(referred to as"national negotiation drugs"),and promote the implementation and use of these drugs in medical institutions.METHODS Based on the complex institutional environment in which medical institutions were situated,the theory of multiple institutional logics was used to construct an analytical framework for the behavioral choices of medical institutions,and reveal the mechanism of the difficulty in the use of national negotiation drugs by clarifying the interaction and conflict of multiple logics in this process,so as to put forward some measures.RESULTS&CONCLUSIONS There were contradictions and coupling among the state logic,market logic,social logic and professional logic in the use of national negotiation drugs.In the game of multiple logics,the market logic and professional logic tended to be risk-averse,the failed"pressure-type system"of state logic,and the social logic was weakened,which caused the lack of action in the use of national negotiation drugs with the goal of completing performance evaluations in the current medical institutions.Thus,it is suggested to unbundle the invisible policy restrictions on the use of national negotiation drugs,form the pressure and motivation of medical institutions by incentive and constraint mechanisms,respond to the clinical demand by establishing a green procurement channel,and construct the supervision mechanism on the use of national negotiation drugs by social force,etc.,so as to enhance the effect of the national negotiation drugs.关键词
医保谈判药品/多重制度逻辑/医疗机构/制度环境/行为选择Key words
medical insurance negotiation drugs/multiple institutional logics/medical institutions/institutional environment/behavioral choices分类
医药卫生引用本文复制引用
李梦颖,伍琳,王昕妍,陈永法..我国医保谈判药品落地问题的多重制度逻辑分析与政策建议[J].中国药房,2024,35(14):1683-1689,7.基金项目
国家自然科学基金青年项目(No.72304280) （No.72304280）
国家级大学生创新创业训练计划项目(No.202410316043Z) （No.202410316043Z）
江苏高校哲学社会科学研究一般项目(No.2022SJYB0073) （No.2022SJYB0073）
