新医改背景下我国城镇地区医疗机构的药品配备及使用情况分析

发布时间：2018-10-05 09:29

【摘要】：目的 :从不同级别医疗机构出发,旨在分析新医改下我国城镇地区医疗机构的药品配备和使用情况。方法 :采用结构化的医疗机构调查表,在杭州市和宝鸡市分别调查了20家不同级别医疗机构,收集其基本情况、药品配备种类、药品收入等信息。结果 :整体而言,两市的医疗资源分布略有差异,杭州市医疗机构配备的药品种类数远高于宝鸡。2009—2013年间,杭州市基层医疗机构总体配备的药品种类数、基本药物配备种类数和抗生素种类都呈下降趋势;除抗生素外,二级和三级医院的配备药品总数、基本医疗保险目录内药品总数略有上升。杭州市医疗机构药品费用占机构总收入的比例高于宝鸡市,调查年份内不同级别医疗机构超过一半以上的收入来源于药品收入。此外,虽然基层医疗机构药品收入占比高于三级和二级医院,但可以观察到该指标呈现较为明显的下降趋势。宝鸡市不同级别医疗机构除抗生素外,药品配备总数、目录内药品总数整体呈现上升趋势。结论 :国家基本药物制度和基层医疗机构改革对城镇地区基层医疗机构的药品配备起到了决定性作用,药品收入的增长也得到了控制。但如何在不影响医疗服务质量的基础上,改善二级和三级医疗机构的合理用药,降低药品费用占医疗机构总收入的比例,仍然是需要研究的问题。
[Abstract]:Objective: to analyze the medical equipment and use of medical institutions in urban areas under the new medical reform. Methods: 20 medical institutions of different levels were investigated in Hangzhou and Baoji by using structured questionnaire of medical institutions. The basic information, kinds of drugs and income of drugs were collected. Results: as a whole, the distribution of medical resources was slightly different between the two cities. The number of drugs provided by medical institutions in Hangzhou was much higher than that in Baoji from 2009 to 2013, and the total number of drugs provided by primary medical institutions in Hangzhou was higher than that in Hangzhou between 2009 and 2013. The number of essential drugs and the types of antibiotics decreased, except for antibiotics, the total number of drugs in the secondary and tertiary hospitals and the total number of drugs in the basic medical insurance catalogue increased slightly. In Hangzhou, the proportion of medical expenses to the total income of medical institutions is higher than that of Baoji City, and more than half of the income of medical institutions at different levels in the year under investigation comes from the income of drugs. In addition, although the proportion of drug income in primary medical institutions is higher than that in tertiary and second-level hospitals, it can be observed that the index shows an obvious downward trend. Besides antibiotics, the total number of drugs and the total number of drugs in the catalogue of different levels of medical institutions in Baoji City are on the rise. Conclusion: the national essential drug system and the reform of primary medical institutions have played a decisive role in the provision of drugs in primary medical institutions in urban areas, and the growth of drug income has also been brought under control. However, how to improve the rational use of drugs in secondary and tertiary medical institutions without affecting the quality of medical service, and to reduce the proportion of drug cost to the total income of medical institutions, is still a problem to be studied.
【作者单位】：复旦大学公共卫生学院卫生部卫生技术评估重点实验室健康风险预警治理协同创新中心;
【基金】：世界卫生组织卫生政策与系统研究联盟(Alliance for Health Policy and System Research)资助(ATM2012-01-CHINA)
【分类号】：R95

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