| 引用本文：苏澎, 段光锋, 倪思明, 许宏, 田文华.上海市公立三级综合医院医药分开试点对门急诊用药行为的影响[J].中国卫生政策研究,2016,9(6):10-14 |
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| 上海市公立三级综合医院医药分开试点对门急诊用药行为的影响 |
| 投稿时间：2016-02-09 修订日期：2016-04-20 PDF全文浏览 HTML全文浏览 |
| 苏澎1, 段光锋1, 倪思明2, 许宏3, 田文华4 |
1. 第二军医大学卫生勤务学系 上海 200433;
2. 上海市医疗保险协会 上海 200052;
3. 上海市人力资源和社会保障局 上海 200125;
4. 复旦大学社会发展与公共政策学院 上海 200433 |
| 摘要:目的：分析和评估医药分开政策对公立三级综合医院医生门急诊用药行为的影响。方法：从医保角度，对4家试点医院和3家对照医院的医生门急诊用药行为进行对比分析。结果：平均每张处方用药品种数、注射剂使用率、基本药物使用率差异不明显，抗菌药使用率试点医院明显低于对照医院；平均每张处方药品费用试点医院高于对照医院，但是处方率试点医院低于对照医院。结论：医药分开政策尚未对医生的用药行为产生明显影响；从医生及患者的用药习惯、药品供销的利益链及医药分开试行范围分析可知，促进医生合理用药仍需综合多方措施。 |
| 关键词:公立三级综合医院 医药分开 用药行为 |
| 基金项目:上海市医保协会委托项目 |
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| Effects of separating drug sales from medical services on the prescribing behavior among outpatients and emergency services in the general tertiary public hospitals of Shanghai |
| SU Peng1, DUAN Guang-feng1, NI Si-ming2, XU Hong3, TIAN Wen-hua4 |
1. Faculty of Health Service, the Second Military Medical University, Shanghai 200433, China;
2. Shanghai Health Insurance Association, Shanghai 200052, China;
3. Shanghai Municipal Human Resources and Social Security Bureau, Shanghai 200125, China;
4. School of Social Development and Public Policy, Fudan University, Shanghai 200433, China |
| Abstract:Objective: To analyze and evaluate the effects of separating drug sales from medical services on the prescribing behaviors among outpatient and emergency services in the general tertiary public hospitals. Methods: From the perspective of medical insurance, the above mentioned prescribing behaviors were analyzed between four pilot hospitals and three control hospitals. Results: There was no obvious difference in the average number of drugs per prescription, the rate of injection usage, and the rate of essential drugs utilization. The antibiotic usage was higher in the pilot hospitals than in control ones, but the average cost per prescription was significantly lower in pilot hospitals than in control hospitals. Conclusion: From the analysis of data, the “separating drug sales from medical services” policies had no significant impact on the prescribing behavior. After analyzing the drug use habits of doctors and patients and the pharmaceutical supply and marketing interest chain, more comprehensive multi-measures are needed to promote rational drug use. |
| Key words:General public tertiary hospital Separating drug sales from medical services Prescribing behavior |
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