| 引用本文：罗尔丹, 李林贵, 卞鹰.西部农村乡级医疗卫生机构合理用药的地区差异研究[J].中国卫生政策研究,2016,9(10):19-24 |
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| 西部农村乡级医疗卫生机构合理用药的地区差异研究 |
| 投稿时间：2016-06-22 修订日期：2016-08-26 PDF全文浏览 HTML全文浏览 |
| 罗尔丹1, 李林贵2, 卞鹰1 |
1. 澳门大学中华医药研究院 澳门 999078;
2. 宁夏医科大学管理学院 宁夏银川 750004 |
| 摘要:目的：通过分析西部农村乡级医疗卫生机构门诊处方数据，评价其用药的合理程度，探讨其中存在的地区差异现象，分析其原因，并提出相应的建议。方法：选取西部七个省（自治区）农村地区57家乡镇卫生院，随机抽取11 495张门诊处方数据，依照WHO针对发展中国家制定的合理用药参考标准，描述各地合理用药整体情况，比较各地不合理用药情况的差异。结果：中国西部七省乡镇卫生院平均单张处方用药3.7种；抗菌药物处方和注射处方比例分别高达59.5%和33.5%，均显著超出WHO标准平均值。不同地区不合理用药情况存在差异，其中新疆的不合理用药情况较其他省（自治区）而言更为严重，其抗菌药物处方比例为77.3%，超出WHO标准平均值230.3%；处方基本药物比例为43.0%，低于WHO标准平均值50.6%；处方费用平均为119.5元，是其他省份的3倍以上。广西激素处方比例高达16.6%，是其他省（自治区）的两倍，超出WHO标准平均值232.0%。西藏地区除抗菌药物处方比例超标以外，其他均符合WHO标准。结论：由于地区特点和卫生政策在地区间的落实情况不同，我国西部农村乡级医疗卫生机构合理用药情况存在地区差异，相关部门应根据地区特点适当调整卫生政策，落实各地基本药物财政补贴，将合理用药纳入医疗工作的绩效评估体系，改善各地用药的合理性。 |
| 关键词:合理用药 地区差异 农村 医疗卫生机构 处方 |
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| Regional differences of the rational use of drugs in rural healthcare facilities in western China |
| LUO Er-dan1, LI Lin-gui2, BIAN Ying1 |
1. Institute of Chinese Medical Sciences, University of Macau, Macau 999078, China;
2. School of Management, Ningxia Medical University, Yinchuan Ningxia 750004, China |
| Abstract:This study intends to analyze the prescriptions in rural health facilities in western China to evaluate the rational use of drugs and explore the regional differences in the rational drug use among rural areas in western China. A total of 11495 prescriptions were selected from 57 township hospitals in rural areas of 7 provinces in western China in 2011. Indicators were evaluated with the standard guidance of WHO to describe the rational drug use and estimate the differences in the rational drug use among these areas. The results of this investigation show that among all the 7 provinces, the average number of drugs per prescription was 3.7, and the percentage of prescriptions including antibiotics was 59.5%, which was 154.3% more than the average standard of WHO, and the percentage of prescriptions including injections was 37.7%, which was 78.2% more than the standard. Particularly, the indicators of rational drug use in Xinjiang was more critical than the others, as that the percentage of prescriptions including antibiotics in Xinjiang was 77.3%, which was 230.3% more than the standard, and the percentage of prescriptions including NEDL drugs in Xinjiang was 43.0%, which was 50.6% less than the standard. Guangxi was shown in the percentage of prescriptions including hormones, which is 16.6%, and twice more than the others. Tibet was more rational than the others in drug using. Based on the findings of this study, it is witnessed that there are regional differences in the rational use of drugs among rural health facilities in western China, showing that Xinjiang as serious irrational drug use, while Tibet as in relatively rational drug use. This study suggests that health policy should be adjusted based on regional characteristics, especially the fiscal subsidy of essential medicines should be implemented, and the rational drug use should be added into the performance evaluation of medical work. |
| Key words:Rational use of drugs Regional difference Rural Healthcare facilities Prescription |
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