我国农村地区合理用药干预优先策略研究

Priority Intervention Strategies of Rational Use of Drugs in Rural Areas in China

目的:确定我国农村地区合理用药优先干预策略。方法:采用文献法、现场调查法、专家法、Stakeholder分析法、聚类分析法,对我国农村地区开展的合理用药干预策略进行分析。结果与结论:当前我国农村地区开展合理用药的干预策略主要有3类:第1类为优先策略,包括制订和采用农村医疗机构诊疗规范、采用专用处方、制订和采用《基本药物目录》等;第2类为次优先策略,包括加强合理用药督导、审核和反馈等;第3类为参考策略,包括理顺补偿机制并加大对医疗机构的补偿力度、细化农村基层医疗机构药品监管法规等。第1类策略因相关利益集团的实施意愿和实施能力均较强,最具可行性。

OBJECTIVE：To study the priority intervention strategies of rational use of drugs in rural areas of our country. METHODS：The priority intervention strategies of rational use of drugs in rural areas were analyzed by literature review, field investigation,Delphi method,stakeholder analysis and cluster analysis.RESULTS ＆ CONCLUSION：The current intervention strategies of rational use of drugs adopted in rural areas consist of 3 categories： the first one is priority intervention strategies, which include setting and enforcing diagnostic and treatment guidelines, enforcing special- purpose prescriptions, Essential Drug Lists and so on;the second category is the sub- priority strategies, which includes supervising, auditing and feedback on rational use of drugs etc, and the tertiary category is the reference strategies, which includes managing reimbursement mecha- nism and intensifying reimbursement in medical institutions, detailed classification of rural drug control regulations etc. Of whi- ch, the first category is the most feasible one because of stakeholders＇ strong desire and ability to implement these strategies.