我国基本药物增补数量的影响因素、适宜性和控制方法研究

Quantity of Essential Drugs Supplement in China:Influential Factors,Reasonability and Control Methods

目的:为完善我国地方基本药物目录增补制度提供参考。方法:采用Excel2007和Stata10.0对指标进行相关性检验和主成分回归分析。分析当前地方基本药物目录增补规律,判断其合理性,提出在宏观层面控制地方基本药物增补数量的建议。结果与结论:(1)基本药物增补数量主要受到地区经济水平和居民卫生服务需要的影响,其次是基层卫生服务提供水平,累积贡献率为80.19%。(2)经分析,不同区域基本药物增补数量可通过如下规则进行预测和控制。人均GDP每增长1万元,基本药物增补3个品种;人均财政收入每增长1000元,基本药物增补2个品种。城镇居民年人均可支配收入每增长1000元,基本药物增补1个品种;农村居民年人均纯收入每增加1000元,基本药物增补2个品种。"新农合"人均筹资每增长100元,基本药物增补5个品种。期望寿命每延长1岁,基本药物增补1个品种。两周患病率每增长10个百分点,基本药物增补6个品种;慢性病患病率每增长10个百分点,基本药物增补7个品种。社区卫生服务中心病床使用率每增长10个百分点,基本药物增补2个品种;乡镇卫生院病床使用率每增长10个百分点,基本药物增补3个品种。笔者根据上述规则制订了地方基本药物增补区间建议表,该表格可为政府宏观控制地方基本药物增补数量提供参考。

OBJECTIVE ： To provide reference for the supplement system of local essential drug list in China. METHODS ： Relevant trial and main component regression analysis were conducted using Excel 2007 and State 10.0. The regularity of local essential drug list supplement was analyzed to determine the rationality of it and put forward some suggestions on quantity control of local essential drug supplement from macroscopic aspect. RESULTS ＆ CONCLUSION： （1）The quantity of essential drugs supplement is mainly affected by regional economic level and health service needs of residents, followed by basic health service level, the cumulative contribution is 80.19%. （2）The quantity of essential drug supplement in different regions can be predicted and controlled by following rules： 3 varieties of essential drugs are added with ten thousands growth of GDP per capita; 2 varieties of essential drugs are added with one thousand growth of government revenue per capita; one variety of essential drug is added with one thousand growth of urban residents＇ disposable income per capita; 2 varieties of essential drugs are added with one thousand growth of rural residents＇ net income per capita; 5 varieties of essential drugs are added with one hundred growth of the financing per capita of new rural cooperative medical care; 1 variety of essential drugs is added with one year extend of life expectancy; 6 varieties of essential drugs are added with ten percentage points growth of 2 weeks prevalence; seven varieties of essential drugs are added with 10 percentage points growth of chronic diseases prevalence; 2 varieties of essential drugs are added with ten percentage points growth of the occupancy rate of community health service centers; 3 varieties of essential drugs are added with 10 percentage points growth of the occupancy rate of township hospitals. According to above rules, we propose a suggestion table of local essential drugs supplement to provide a reference for government＇s macro-control.