目的 探讨我国公立医院取消药品加成后实施药房托管所面临的问题,并提出对策.方法 采用文献分析结合改革实践等方式,分析药房托管已存在和可能出现的问题,并提出相应对策.结果 随着取消药品加成政策的普及,医院对药房托管的需求与日俱增,但药房托管依然存在利益分配、责任归属、垄断、药学服务削弱、规范医生行为等方面的问题,解决办法也需要多方面协调实施.结论 我国公立医院药房托管是大势所趋,取消药品加成后实施药房托管政策的公立医院也越来越多.解决药房托管问题需要一套完整的政策方案,包括政府、医院及医药公司等各方的共同努力.药房托管作为医疗改革的过渡方式之一,如能在各方的努力下成功解决出现或即将出现的问题,积累实践经验,必定能促进医药分开.%Objective To investigate the problems of implementation of drugstore trusteeship after the cancellation of drug markups in public hospitals in China, and put forward some countermeasures. Methods The existing and possible problems of drugstore trusteeship were analyzed and the corresponding countermeasures were put forward by the means of literature analysis and reform practice. Results With the popularization of the cancellation of drug markups policy, the demand for drugstore trusteeship in the hospitals was increasing day by day. However, there still existed some problems in drugstore trusteeship, such as interest distribution, responsibility attribution, monopoly, weakening of pharmaceutical care, and standardizing doctors′ behavior. There were many ways to coordinate the solution, and the solution also needed to assist to implement in many ways. Conclusion Drugstore trusteeship in public hospitals in China is the general trend, there are more and more public hospitals begin to implement the policy of drugstore trusteeship after the cancellation of drug markups policy. To solve the problem of drugstore trusteeship requires a complete set of policy options, including the joint efforts of all stakeholders, such as the government, the hospital and the pharmaceutical companies. Drugstore trusteeship is one of the transitional ways of health care reform. If we can successfully solve the problems that have occurred or impending problems under the efforts of all parties, we will certainly promote the separation of medicine by accumulating practical experience.
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