上海市慢性病门诊用药现状调查:以高血压、糖尿病为例

发布时间：2018-04-13 22:39

本文选题：合理用药 + 高血压　；参考：《中国卫生资源》2016年03期

【摘要】：目的 :比较分析各级医疗机构慢性病门诊处方行为的合理性与差异性,寻找慢性病患者下沉社区就诊在药品配备与使用方面的障碍因素。方法 :采用整群抽样的方法,抽取医疗机构2014年5月和11月高血压和糖尿病患者处方进行处方合理性分析;采用药物结构治疗化学分类系统及限定日剂量(ATC/DDD)方法分析药品利用情况。结果 :二、三级医疗机构高血压、糖尿病处方费用明显高于社区卫生服务中心;高血压、糖尿病患者主要在社区配药,药品使用类别上略有差异;各级医疗机构高血压、糖尿病用药的采购一致性较差。结论 :缓解或解决社区慢性病患者"配不到药"现象的根源,是解决社区卫生服务中心与二、三级医疗机构的药品配备使用范围的一致性问题,建议适当放开社区慢性病药品配备范围、医保控费额度和处方时长。
[Abstract]:Objective: to compare and analyze the rationality and difference of prescriptive behavior in outpatient clinics of chronic diseases at all levels, and to find out the obstacle factors of drug allocation and use in community visits of patients with chronic diseases.Methods: the prescriptions of patients with hypertension and diabetes in May and November 2014 were analyzed by cluster sampling.The use of drugs was analyzed by ATC / DDD method.Results: second, the prescribing cost of diabetes in tertiary medical institutions was significantly higher than that in community health service centers; the patients with hypertension and diabetes were mainly dispensed in the community, and there was a slight difference in the types of drug use.The procurement consistency of diabetes drugs was poor.Conclusion: to alleviate or solve the root cause of the phenomenon of "unavailability of drugs" for patients with chronic diseases in the community is to solve the problem of consistency between community health service center and the range of drug use in the second and third level medical institutions.It is suggested that the range of drug supply for chronic diseases in community, the amount of medical insurance fee and the time of prescription should be opened.
【作者单位】：复旦大学公共卫生学院;上海市医学科学技术情报研究所上海市卫生发展研究中心卫生政策研究部;上海市卫生和计划生育委员会药政管理处;上海市医药集中招标采购事务所;
【基金】：美国中华医学基金会卫生体系研究与政策转化合作项目(CMB-CP14-190) 上海市卫生和计划生育委员会定向委托课题(2015HP009)
【分类号】：R95

【参考文献】