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医院用药库存政策评估。

Evaluation of hospital medication inventory policies.

机构信息

Department of Mechanical and Industrial Engineering, Montana State University, Bozeman, MT, 59717, USA.

出版信息

Health Care Manag Sci. 2014 Sep;17(3):215-29. doi: 10.1007/s10729-013-9251-1. Epub 2013 Sep 8.

Abstract

As supply chain costs constitute a large portion of hospitals' operating expenses and with $27.7 billion spent by the US hospitals on drugs alone in 2009, improving medication inventory management provides a great opportunity to decrease the cost of healthcare. This study investigates different management approaches for a system consisting of one central storage location, the main pharmacy, and multiple dispensing machines located in each department. Each medication has a specific unit cost, availability from suppliers, criticality level, and expiration date. Event-driven simulation is used to evaluate the performance of several inventory policies based on the total cost and patient safety (service level) under various arrangements of the system defined by the number of drugs and departments, and drugs' criticality, availability, and expiration levels. Our results show that policies that incorporate drug characteristics in ordering decisions can address the tradeoff between patient safety and cost. Indeed, this study shows that such policies can result in higher patient safety and lower overall cost when compared to traditional approaches. Additional insights from this study allow for better understanding of the medication inventory system's dynamics and suggest several directions for future research in this topic. Findings of this study can be applied to help hospital pharmacies with managing their inventory.

摘要

由于供应链成本占医院运营成本的很大一部分,而且 2009 年美国医院仅在药品上就花费了 277 亿美元,因此改善药品库存管理为降低医疗成本提供了很好的机会。本研究调查了由一个中央存储位置(主药房)和多个位于每个部门的配药机组成的系统的不同管理方法。每种药物都有特定的单位成本、供应商的供应情况、关键程度和有效期。基于系统的各种排列(药物数量和部门数量、药物的关键程度、供应情况和有效期),使用事件驱动的模拟来评估基于总成本和患者安全性(服务水平)的几种库存策略的性能。我们的结果表明,在订购决策中纳入药物特征的策略可以解决患者安全性和成本之间的权衡问题。事实上,与传统方法相比,本研究表明,这种策略可以提高患者安全性并降低总体成本。本研究的其他见解可以更好地理解药物库存系统的动态,并为该主题的未来研究提出几个方向。本研究的结果可用于帮助医院药房管理其库存。

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