基本药物制度实施后乡镇卫生院药品用量及结构的变化:以山东省三县为例

Changes of Drugs' Usage and Structure of Township Hospitals under Essential Medicine System: Cases in Three Counties of Shandong Province

目的:研究基本药物制度实施前后乡镇卫生院基本药物的用量及其结构变化。方法:定量资料调查改革前后样本卫生院基本药物的品种及用量,分析方法采用描述性统计分析和卡方检验,并辅以定性访谈资料。结果:实施基本药物制度以后,药品用量整体上升,经济较好的县、一般卫生院和高价药品的用量增长幅度较大,经济一般和较差的县及中心卫生院增幅相对较小。结论:实施基本药物制度以后,药品用量整体上升,但因有些地区政府补助不足,缺乏科学的激励机制,导致高价药用量增幅较大,可能存在一些不合理用药的现象。

Objective： To research the changes of drugs＇ usage and structure of township hospitals under essential medicine system. Method： Collecting the amount of essential drugs and their usage of township hospitals before and after the implementation of essential medicine system as the quantitative data, choosing descriptive statistics and ehi-square test as the statistical methods, and combining with qualitative interview data from survey site. Results： Overall amount of drug use increases under the essential medicine system. County-level health care center of better economic, general township hospitals and higher-priced drugs increase largely. Medium and poor county-level economic and center township hospitals have a smaller increase. Conclusion： After the implementation of essential medicine system, the drug usage increases overall; hut the amount of high-priced drugs increases greatly because of the system of some area lack of government subsidies and scientific incentives. There may be some phenomenon of the irrational use of drugs.