基于因子分析法的云南省药品短缺影响因素调查

黄润青 段文越 翁稚颖 陈李平 曹人元 李璠

中图分类号 R95 文献标志码 A 文章编号 1001-0408（2018）17-2315-04

DOI 10.6039/j.issn.1001-0408.2018.17.03

摘 要 目的：分析造成药品短缺的相关因素，为提高药品供应的可及性提供参考。方法：在文献研究的基础上归纳与药品短缺相关的影响因素，设计调查问卷（包括18条药品短缺影响因素调查表和开放性问答两部分），采用分层整群抽样在云南省抽取6个州、市，调查对象为生产企业、流通企业、医疗机构的相关部门负责人，运用主成分分析法提取公因子。结果与结论：共发放问卷550份，收回问卷535份，合格问卷531份。主成分分析共提取出4个公因子对造成药品短缺有较大的影响，其影响程度由大到小依次为价格因子、产能因子、需求因子、使用因子（标化系数分别为0.54、0.51、0.48、0.47）。建议政府部门应完善药品价格政策，发挥监管者职能；医疗机构应提高合理用药水平，探索建立短缺药品的科学管理体系；生产企业、流通企业应积极参与监测，提高规则意识和社会责任意识。

关键词 药品短缺；药品供应；影响因素；因子分析法；原因分析

ABSTRACT OBJECTIVE： To analyze the relevant factors of drug shortage， and to provide reference for improving the availability of drug supply. METHODS： Based on literature study， influential factors related to drug shortage were summarized to designed questionnaire （including 18 influential factors of drug shortage and opening answer）. Stratified cluster sampling was used to collect 6 states and cities in Yunnan province. Questionnaire survey was conducted among relevant persons in charge of production enterprises， circulation enterprises and hospitals. The common factors were collected with principal component analysis. RESULTS & CONCLUSIONS： Totally 550 questionnaires were sent out， and 535 questionnaires were collected， involving 531 valid questionnaires. The principal component analysis extracted 4 common factors which greatly influenced drug shortage. Those factors in descending order of impact degree were price factor， production capacity factor， requirement factor and usage factor （the standard coefficient was 0.54， 0.51， 0.48， 0.47， respectively）. The government is suggested to improve drug price policy and play the function of the supervisor. Medical institutions should improve rational drug use， explore and establish scientific management system of shortage drugs. Production and circulation enterprises should participate in monitoring actively and raise the awareness of rules and awareness of social responsibility.

KEYWORDS Drug shortage； Drug supply； Influential factors； Factor analysis； Reason analysis

短缺藥品是指在一定区域和一定时间内不能正常供应的药品，“使用”端的药品短缺问题是全球难题，其关系到治疗的及时性、科学性、有效性及经济性[1]。改革开放以来，我国已经基本告别了“缺医少药”的时代，但依然有一部分临床必需、疗效确切、无法替代的药品出现短缺问题，影响患者临床用药、危及群众生命健康，引起了社会的广泛关注。2017年，《国务院办公厅……