建立中药产业的比较优势

随着经济市场化，全球化进程加快，我国传统农业在经历转型的阵痛。走质量效益型道路已成为农业现代化的必然选择，不同学者已经从不同的角度作了有益的探索，中国药产业在上游阶段同农业生产存在密切的联系，通过创新性地发展传统中药行业，建立中药产业比较优势，是推动农业现代化进程的一种值得考虑的途径。     

Quantifying the defensive medicine contribution to primary care costs

Background:

Defensive medicine represents one cause of economic losses in healthcare. Studies that measured its cost have produced conflicting results.

Objective:

To directly measure the proportion of primary care costs attributable to defensive medicine.

Research design and methods:

Six-week prospective study of primary care physicians from four outpatient practices. On 3 distinct days, participants were asked to rate each order placed the day before on the extent to which it represented defensive medicine, using a 5-point scale from 0 (not at all defensive) to 4 (entirely defensive).

Main outcome measures:

This study calculated the order defensiveness score for each order (the defensiveness/4) and the physician defensive score (the mean of all orders defensiveness scores). Each order was assigned a weighted cost by multiplying the total cost of that order (based on Medicare reimbursement rates) by the order defensiveness score. The proportion of total cost attributable to defensive medicine was calculated by dividing the weighted cost of defensive orders by the total cost of all orders.

Results:

Of 50 eligible physicians, 23 agreed to participate; 21 returned the surveys and rated 1234 individual orders on 347 patients. Physicians wrote an average of 3.6?±?1.0 orders/visit with an associated total cost of $72.60?±?18.5 per order. Across physicians, the median physician defensive score was 0.018 (IQR?=?[0.008, 0.049]) and the proportion of costs attributable to defensive medicine was 3.1% (IQR?=?[0.5%, 7.2%]). Physicians with defensive scores above vs below the median had a similar number of orders and total costs per visit. Physicians were more likely to place defensive orders if trained in community hospitals vs academic centers (OR?=?4.29; 95% CI?=?1.55–11.86; p?=?0.01).

Conclusions:

This study describes a new method to directly quantify the cost of defensive medicine. Defensive medicine appears to have minimal impact on primary care costs.     

宫颈康凝胶治疗人乳头瘤病毒感染宫颈炎的临床研究

目的分析宫颈康凝胶治疗宫颈炎合并人乳头瘤病毒(HPV)感染的临床疗效。方法选择我院妇科门诊确诊的宫颈炎合并HPV感染患者125例,按随机双盲对照法分为三组,宫颈康组(50例)采用宫颈康凝胶;保妇康组(45例)采用保妇康凝胶;空白对照组(30例)采用空白凝胶分别阴道给药治疗,对检测结果进行统计学分析。结果 HPV疗效队列为宫颈康组(82.00%)>保妇康组(71.11%)>空白对照组(13.33%);宫颈炎疗效队列为宫颈康组(84.00%)>保妇康组(68.89%)>空白对照组(16.67%);P<0.01或<0.001。结论宫颈康凝胶对HPV感染疗效确切,适合临床抗HPV感染应用。     

弱势群体的医保视角:我国药品流通领域缺陷及对国外的借鉴

弱势群体对社会福利的需求最为迫切,也是我国基本医疗保险制度最不可忽视的群体。但我国目前的药品流通领域弊端对他们享受医保带来了负面压力。本文针对我国现状,结合国外药品流通领域的相关情况,提出了一些完善我国药品流通领域的建议。     

中药研究中几种新技术的应用

现代新技术的快速发展，促进了中药现代化的进程。该文阐述了生物芯片技术、超微粉体技术、超临界流体萃取技术、分子蒸馏、超声技术、微波技术在中药研究领域中的应用。     

重庆市医药产业企业竞争力研究

重庆医药产业经过近几年的发展已初具规模,产业竞争力初步显现.当前应乘势而进,从提升产业综合素质入手,加强自主创新,加大研发投入对自主知识产权药品的开发,积极开拓市场,完善政策环境,把重庆医药产业做强做大,让产业的潜能得到充分释放.     

天水市中药材产业供给侧改革之路的思考

[目的]为解决中药材套种立体栽培模式不完善,土地资源利用不充分,植株空间分布不合理的问题,针对我市林缘区面积较大的实际,按照"调结构、保质量、降成本、补短板、创品牌"的总体要求,选择重楼、五味子、猪苓、天麻4种中药材,在中药材立体仿生栽培技术方面进行研究,以期实现天水市中药材由生产大市向产业强市转变,促进农业增效、农民增收。[方法]采取架上五味子,架下重楼,地下猪苓(天麻)的立体仿生种植模式,通过五味子、重楼、猪苓(天麻)立体仿生栽培技术能够实现了优势互补,提高了土地利用率,便于抚育管理,降低了生产经营成本,提高了劳动生产率,实现了同一地块空间资源利用,提高了单位面积的经济效益。[结果]通过5年试验,从产量角度看模式Ⅱ(五味子+重楼+天麻)最优,其次是模式Ⅲ(五味子+重楼+天麻+猪苓);从经济效益看模式Ⅰ(五味子+重楼+猪苓)最好,其次是模式Ⅲ。[结论]3种模式均较单种的收益有大幅度提高。     

政府支持与地方产业发展研究——湖北省蕲春县“医药兴县”战略效果反思

湖北省蕲春县依托当地的人文资源以及药材种植、加工的优势提出了"医药兴县"的战略,并在税收、种苗补贴、中医药产业、旅游、中医药人才、中医医疗保险等方面给予政策支持。由于中医药行业本身的问题,影响政府扶持作用的效果发挥。中医药本身的弱质性,中药材作为经济作物的种植,不具有自给自足性,市场的波动容易影响农民种植的积极性。中医药产业对本地药材种植的带动作用效果明显,但深度与广度显著有限。"医药兴县"是一种特色,是一种努力的方向,但是实际中医药产业在整个县域经济体系中占比并不高,对农村农业的发展带动不大,对农民的实际收入贡献度不高。     

大熊猫自然保护区中药材种植户持续种植意愿的影响因素

基于陕西长青自然保护区周边192种植户的实地调研数据,运用二元logistic模型,分析了种植户扩大中药材种植规模意愿的影响因素。结果表明:受教育程度、种植规模、中药材培训及价格、政府的资金与技术支持等对中药材持续种植意愿有正向影响;外出务工劳动力数量、种植成本、雇(换)工情况等成为扩大种植规模的主要限制因素。为了推进中药材产业规模化经营,可在政策、技术和资金等方面给予支持,建立中药材市场机制、完善保险体系。