Современные проблемы розничной торговли лекарственными средствами через обособленные подразделения медицинских организаций в Новосибирской области

Abstract

Introduction. Low population density, complexity of drug delivery, a low level of solvency of rural population, the insufficiently developed infrastructure of pharmaceutical care, shortage of pharmaceutical specialists in municipal districts make remote territories unattractive for the development of retail trade of medicines, whereas the inconsistency of state programs for social and economic development of rural areas, the timing of their implementation, different departmental orientation, insufficient funding do not allow achieving the targets, which requires an in-depth study of the problems and determining the directions for optimizing retail trade of medicines. Aim. The study of modern problems of retail trade of medicines via separate divisions of medical facilities in the Novosibirsk region (NR). Materials and methods. The sources of information were the main health indicators of the NR for 2022, departmental materials of the Ministry of Health of the NR, questionnaires of primary care workers, the register of licenses for pharmaceutical activities in the NR, financial reports of the central district hospitals of the NR for 2022 for 30 municipal districts of the region. According to specially designed questionnaires, 95% of the total number of primary care workers involved in the retailing of medicines via separate divisions of the NR medical organizations (917) were interviewed. Results. In one third (9) of the municipal districts of the NR, the population served by one pharmacy organization is 3057 people, which is characterized as very high and corresponds to low geographic availability of pharmaceutical care. The average number of rural population served by one pharmacy organization in municipal districts in 2022 was 2138 people. According to the number of rural residents per one medical and obstetric station (MOS), the first, second and third groups of municipal districts are the most numerous and available (a total of 22) in which there are from 278 to 531 residents per one MOS, which is 73.33%, and in the rest 8 (26.66%) municipal districts, the average number of rural residents ranges from 718 to 1051, thus exceeding the indicator of the 1st group by 3.78 times. The most cost-effective are the drugs included in the first priority group (398 trade names (TN)) which has high indicators in terms of the amount of drugs sold and the number of packages dispensed, but the proportion of drugs of this group is small – 10.75%. The second priority group included 687 TN. The group has average indicators, it accounts for 18.55%. The third priority group consists of drugs with low indicators in terms of the amount of drugs sold and number of packages dispensed (2618 TN; the group’s proportion is 70.70%). The survey of primary care workers showed that only 20.7% of respondents are satisfied with the level of knowledge and skills they have. Primary care workers of MOS experience the greatest difficulties in the order of prescribing medication, accounting and storage of drugs, medical devices and other goods of pharmacy range (57.8%). Conclusion. As a result of the study, 6 groups of municipal districts were identified according to the geographic availability of retailing entities for the subsequent formation of individual development trajectories. The analysis of the realized range of drug allowed us to develop proposals for its optimization for retail trade via MOS. The results of the survey of primary care workers require the development of additional training programs for the retail trade of medicines, making reasonable management decisions to optimize retail trade.