社区卫生服务中心延伸处方政策的实践与思考

The practice and reflection of extended prescription policy in the community health service centers

目的:探讨上海市社区卫生服务中心延伸处方政策实施2年来的情况。方法:通过分析嘉定区13家社区卫生服务中心2016、2017年延伸处方的采购数据库,对延伸处方量、药品金额及药品药理分类等进行统计分析。结果:2016、2017年的延伸处方量分别为8 850张、68 468张,2017年的处方量为2016年的7.74倍;2016、2017年的延伸处方金额分别为198万元、1 939万元,2017年为2016年的9.79倍。延伸处方中非基本药品品种为240种,占76.68%;51.26%的延伸处方化学药品有相同通用名药品可替代。结论:社区居民对延伸处方模式需求量高,但对相同通用名药物替代接受程度不高,应重视非基本药品的安全性并建立通用名替代制度,确保社区居民延伸处方的用药安全。

Objective： To explore the implementation of extended prescription policy in Shanghai community health service centers over the past two years. Methods： Through the analysis of the procurement database of extended prescriptions in 13 community health service centers in Jiading District in 2016 and 2017, the extended prescription quantity, drug amount and pharmacological classifcation of drugs were statistically analyzed. Results： The number of extended prescriptions for 2016 and 2017 were 8 850 and 68 468 respectively, and the amount of prescription in 2017 was 7.74 times as much as that in 2016; the amounts of extended prescription in 2016 and 2017 were 1.98 million Yuan and 19.39 million Yuan, respectively and in 2017 it was 9.79 times that in 2016. There were 240 kinds of non-essential drugs in extended prescription, accounting for 76.68%; 51.26% of extended prescription chemicals had the same generic name as alternatives. Conclusion： The demand for extended prescriptions is high among the community residents; however, the degree of substitution for the same generic name drug is not high. The safety of non-essential drugs should be paid attention to and a general name substitution system should be established to ensure the safety of extended prescriptions for community residents.