| 引用本文：林腾飞,胡明,吴佳怡.四川省农村基层医疗机构基本药物制度实施效果研究[J].中国卫生政策研究,2013,6(10):48-53 |
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| 四川省农村基层医疗机构基本药物制度实施效果研究 |
| 投稿时间：2013-05-17 修订日期：2013-09-30 PDF全文浏览 HTML全文浏览 |
| 林腾飞, 胡明, 吴佳怡 |
| 四川大学华西药学院 四川成都 610041 |
| 摘要:目的:分析四川省农村基层医疗机构基本药物制度实施效果,为完善基本药物制度提供实证依据与对策建议。方法:比较国家基本药物制度实施前后,样本地区农村基层医疗机构基本药物可获得性、合理用药情况、基本药物可负担性等指标的变化。结果:国家基本药物制度实施后,药品收入占医疗机构总收入比例下降,财政补助占比上升;样本医疗机构国家基本药物配备率中位数为50.81%;次均处方费用从23.95元降至21.23元,含抗生素处方率从71.06%降至68.37%,含注射剂处方比率从32.27%降至29.70%。基本药物可负担性提高,但部分仍超过了农村居民收入可负担范围。结论:基层医疗机构财政补偿机制转变;基层医疗机构"两降两升"效果未完全显现;基层医疗机构基本药物配备使用率不足;基本药物价格下降,可负担性仍有待提高;基层医疗机构合理用药问题仍待改善。 |
| 关键词:基层医疗机构 基本药物制度 效果 |
| 基金项目:国家自然科学基金资助项目(71103125) |
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| National essential medicine system in primary medical institutions in rural Sichuan |
| LIN Teng-fei, HU Ming, WU Jia-yi |
| West China School of Pharmacy, Sichuan University, Sichuan Chengdu 610041, China |
| Abstract:Objective: To analyse the implementation of National Essential Medicines System (NEMS) in primary medical institutions in rural Sichuan and to provide empirical evidence and political advice for perfecting the NEMS in Sichuan. Methods: The availability, affordability and rational use of essential medicines in these institutions before and after NEMS were analyzed. Results: After implementation of NEMS, the average gross income from drugs for the sampled institutions decreased, and the average government subsidies increased. The median equipping rate of essential medicines in the sampled institutions increased to 50.81%; the average cost of prescriptions decreased from 23.95 yuan to 21.23 yuan; the ratio of prescriptions containing injections fell from 71.06% to 68.37%; and the ratio of prescriptions containing antibiotics fell from 32.27% to 29.70%. The NEMS has contributed a great deal making essential medicines more affordable, but low-income people still cannot afford some essential medicines. Conclusions:The financial compensation mechanism changed. The effects of the NEMS on reducing medical costs and increasing the number of patients in primary medical institutions have yet to be fully achieved. The equipping and using rates of essential medicines in the sampled institutions were inadequate, even though the price of essential drugs has dropped. Essential medicines still need to be made more affordable, and rational use of drugs in primary medical institutions needs to be promoted. |
| Key words:Primary medical institutions Essential medicines Effect |
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