国家基本药物制度下黑龙江

发布时间：2018-09-08 14:19

【摘要】：目的:为推动乡镇卫生院进一步实施国家基本药物制度提供依据。方法:通过发放调查表获取黑龙江省"卫十一项目"地区所有乡镇卫生院国家基本药物制度实施前后的基本情况,并采用随机系统整群抽样方法抽取2008年和2012年全年中的4天的处方,进行统计和对比分析,评价用药合理性。结果:2009年与2013年两次调查分别回收乡镇卫生院机构调查表各40份,处方3 173张和4 197张。该地区2012年与2008年比较,平均执业(助理)医师比例增加了1.5%,平均床位数增加了4.6张,次均处方药品品种数由2.9种下降到1.7种,输液率由46.5%下降到30.6%,抗菌药物使用率由61.5%下降到40.0%,两种及以上抗菌药物联用率由18.9%下降到4.8%,激素使用率由11.9%下降到4.2%,抗菌药物/激素联用率由9.2%下降到2.8%;次均门诊和住院药品费用分别下降了19.1%和16.4%,差异均有统计学意义(P0.05)。结论:实施国家基本药物制度以后,黑龙江省"卫十一项目"地区乡镇卫生院用药合理性得到显著改善,特别是在处方药品数量、抗菌药物/激素联用率、激素使用率、药品费用等方面达到了政策目标;在输液率、抗菌药物使用率等方面虽也改善显著,但与政策目标还有一定差距;显著下降的次均药品费用并没有带来次均诊疗费用的下降,反而略有上升。
[Abstract]:Objective: to provide evidence for further implementation of national essential drug system in township health centers. Methods: the basic information of the national essential drug system of all township health centers in Heilongjiang Province before and after the implementation of the National essential Drug system was obtained by issuing questionnaires. The prescriptions of 4 days in the whole year of 2008 and 2012 were sampled by random system cluster sampling method and analyzed statistically and comparatively to evaluate the rationality of drug use. Results: in 2009 and 2013, 40 questionnaires and 4 197 prescriptions of 3 173 Zhang He were collected respectively. In 2012, compared with 2008, the average proportion of practising (assistant) physicians increased by 1.5 and the average number of beds increased by 4.6, and the average number of prescribed drugs decreased from 2.9 to 1.7, The infusion rate decreased from 46.5% to 30.6%, the use rate of antimicrobial agents decreased from 61.5% to 40.0kum, the combined use rate of two or more antibiotics decreased from 18.9% to 4.8%, the rate of hormone use decreased from 11.9% to 4.2%, the rate of combined use of antibiotics and hormones decreased from 9.2% to 2.8%; The cost of drugs for consultation and hospitalization decreased by 19.1% and 16.4 respectively, the difference was statistically significant (P0.05). Conclusion: after the implementation of the national essential drug system, the rationality of drug use in township health centers in Heilongjiang Province has been significantly improved, especially in the quantity of prescription drugs, the combined use rate of antibiotics and hormones, and the utilization rate of hormones. The cost of drugs and other aspects have reached the policy goal; although the infusion rate and the utilization rate of antimicrobial drugs have also improved significantly, but there is still a certain gap with the policy objectives; the significantly decreased sub-average drug costs have not resulted in a decrease in the average cost of diagnosis and treatment. On the contrary, there was a slight increase.
【作者单位】：哈尔滨医科大学卫生管理学院;复旦大学卫生发展战略研究中心/健康风险预警治理协同创新中心;
【基金】：国家自然科学基金面上项目(No.71373062);国家自然科学基金重点项目(No.71333003)
【分类号】：R95

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