| 引用本文：王清波,杨洪伟,赵锋,等.基本药物制度实施后村卫生室门诊服务变化比较——基于东、中、西部6省的抽样调查[J].中国卫生政策研究,2013,6(12):33-40 |
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| 基本药物制度实施后村卫生室门诊服务变化比较——基于东、中、西部6省的抽样调查 |
| 投稿时间：2013-09-25 修订日期：2013-12-03 PDF全文浏览 HTML全文浏览 |
| 王清波1, 杨洪伟2, 赵锋1, 田磊磊1, 杨莉1 |
1. 北京大学公共卫生学院 北京 100191
2. 卫生部卫生发展研究中心 北京 100191 |
| 摘要:目的：比较基本药物制度实施前后东、中、西部6省村卫生室门急诊人次、次均药品费用和次均医药总费用的变化。方法：收集6省130个村卫生室2009—2011年连续36个月的门诊服务监测数据，使用分段时间序列模型进行回归分析。结果：2011年与2009年相比，6省村卫生室门诊次均药品费用、次均医药总费用均下降，降幅约在15%～70%之间，东部的浙江和中部的安徽降幅最大；门急诊人次变化的瞬时水平和长期趋势各省均不相同。结论：国家基本药物制度在村卫生室实施后，各省村卫生室次均药品费用和次均医药总费用的下降幅度存在较大差异，门急诊人次的变化也不尽相同，可能与补偿模式、“新农合”报销范围、乡村一体化管理实施进度、基本药物配备情况、乡村医生待遇等多种因素有关。 |
| 关键词:基本药物制度 村卫生室 门诊服务 医疗费用 时间序列分析 |
| 基金项目:国家自然科学基金（71273016）；教育部人文社会科学研究青年基金项目（10YJC630332）；中澳卫生与艾滋病项目（HSS0907） |
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| Comparison on the change of outpatient service in village clinics after the implementation of essential medicines system：A sample survey of 6 provinces in eastern, central and western China |
| WANG Qing-bo1, YANG Hong-wei2, ZHAO Feng1, TIAN Lei-lei1, YANG Li1 |
1. School of Public Health, Peking University, Beijing 100191, China;
2. China National Health Development Research Center, Beijing 100191, China |
| Abstract:Objective: To compare the change and trend, before and after the implementation of national essential medicines system, of outpatient and emergency visits, drug cost per time and total medical cost in village clinics of six provinces located in eastern, central and western China. Methods: By means of segmented time series analysis, the surveillance data of 36 months from January of 2009 to December of 2011 on 134 village clinics were explored. Results: In 2011, both drug costs per time and total medical cost in outpatient visit declined distinctly about 15% to 70% in each province, compared with the same index in 2009. Zhejiang and Anhui, respectively located in eastern and central China, presented the largest amplitude. While the instantaneous change and the secular trend of outpatient and emergency visits in each province presented huge differences. Conclusion: After the implementation of national essential medicines system in village clinics, the decline of drug costs per time and total medical cost in outpatient visit had different situation among provinces and districts, so did the change of outpatient and emergency visits. It may be related to the provinces economic and social development level, the essential drugs system pilot model, the compensation mechanisms, and also associated with the implementation of rural health service integration management and the cooperation of the New Rural Cooperative Medical Scheme. |
| Key words:Essential medicines system Village clinics Outpatient service Medical cost Segmented time series analysis |
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