基于HRQOL的国家基本药物制度福利效应提升研究

发布时间：2018-04-24 10:36

本文选题：基本药物制度 + 健康相关生命质量　；参考：《南京中医药大学》2017年硕士论文

【摘要】：1研究目的从基本药物制度的健康效应、价格效应和利用效应三大效应的现状和影响因素来分析居民对基本药物制度的福利感受。构建适合我国国情并与国际接轨的基本药物制度福利效应的理论模型和研究方法,并研究其内在机理;分析福利效应的重要影响因素,提出改善的制度设计和实现策略。2研究方法通过在知网,以及维普数据库、Pubmed等数据库,以及网络搜索途径,收集基本药物相关资料;在样本地区搜集医保数据官方统计资料(基本药物价格效应数据采集)以及医疗机构数据提取(基本药物利用效应、基本药物价格效应数据采集),在样本地区进行现场调查;运用线性回归对居民BMI进行线性分析并通过EQ-5D五维量表对样本进行调查;引入药品价格中位比值对价格效应进行分析[1];通过综合指数法和线性回归分析基本药物的利用情况。3主要研究结果经过对在江苏省选取的个体居民进行抽样调查,发现调查个体的文化水平、工作状态和慢性病的患病情况与调查个体的身体质量指数有关。在EQ-5D调查中,能够发现焦虑沮丧这一心理状态明显较于其他四个生理健康状态较差,健康问题较多,在年龄、工作状态和慢性病状况上呈现出梯度效应。价格效应分析中,18种药品价格明显高于国际参考价格。在选取的常用14种药品中,氨氯地平、依那普利和辛伐他汀三种药品由于其较高的价格,给居民带来较高的负担性。在基本药物利用效应的分析,整体江苏省的医疗机构能够得到较为充足的供给。在可获性方面,经过综合指数的计算,可发现由于医疗机构规模限制,服务人口的数量限制,以及机构级别及治疗病种的限制,都可对基本药物可获得性综合水平产生巨大影响。4结论在人群健康测量和EQ-5D调查表的分析过程中,由于调查地区的选择而产生的数据不统一性和分析局限性,得到的数据分析结果稍有偏倚;在药品的价格和供应数据的获得上,因调查选取医疗机构所属区域的差异性,和医疗机构选取的集中性,分析结果未定能适用于所有地域的研究。基本药物制度的福利效应建立在居民对该制度的福利感受,通过健康效应、价格效应和利用效应三方来综合体现其福利效应的实现效果,并就为提高居民健康的大前提的福利效应的提升,提出在上层建筑即鼓励政府大力支持和制度完善、降低用药成本并建立资金救助提高居民的药品可负担性、保障药品供应及加强监督培训等方面意见,提升基本药物制度的福利效应,提高居民的健康水平。
[Abstract]:1 the purpose of this study is to analyze the welfare feelings of the residents on the basic drug system from the health effects of the basic drug system, the price effect and the utilization effect of the three major effects, and to construct the theoretical model and research methods suitable for the basic drug system welfare effect of our country, and study the internal mechanism of the basic drug system. Analysis of the important influence factors of the welfare effect, proposed the improved system design and implementation strategy.2 research methods to collect basic drug related data through the network, the VP database, the Pubmed database, and the network search route, and collect the statistical data of the medical insurance data (the basic drug price effect data collection) in the sample area. And the data extraction of medical institutions (basic drug use effect, basic drug price effect data collection), field investigation in sample area; linear regression is used to carry out linear analysis to the residents' BMI and investigate the sample through EQ-5D five dimension scale; the price effect is analyzed by the ratio of drug price to [1]; through comprehensive index The main study of the use of basic drugs in the number of methods and linear regression analysis.3 results after a sample survey on the individual residents selected in Jiangsu Province found that the cultural level of the individual, the state of work and the prevalence of chronic diseases were related to the body mass index of the individual. In the EQ-5D survey, the anxiety and depression could be found. The mental state was significantly lower than the other four physical health states, with more health problems and a gradient effect on age, working state and chronic disease. In the price effect analysis, the price of 18 drugs was significantly higher than the international reference price. In the selected 14 commonly used drugs, amlodipine, enalapril and simvastatin were three drugs. As a result of the higher price, it brings high burden to the residents. In the analysis of the effect of basic drug use, the overall medical institutions in Jiangsu can get more adequate supply. In the availability of the comprehensive index, it is found that the size limit of the medical institutions, the number of the service population, and the institutional level can be found. The restrictions on the treatment of diseases can have a great impact on the comprehensive level of the availability of basic drugs. In the analysis of the population health measurement and the EQ-5D questionnaire, the results of data analysis resulting from the selection of the survey area are biased and the results of data analysis are biased; at the price and supply data of the drug.4 The benefit effect of the basic drug system is based on the welfare feelings of the residents on the system, which is reflected by three parties through health effect, price effect and utilization effect. The realization effect of the welfare effect is to improve the welfare effect of the big premise of improving the health of the residents, and put forward that in the superstructure, that is to encourage the government to support the government vigorously and improve the system, reduce the cost of drug use, establish the financial aid to improve the affordability of the residents, guarantee the supply of drugs and strengthen the supervision and training, and improve the basic medicine. The welfare effect of the property system improves the health level of residents.

【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R951

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