上海市实施国家基本药物制度对社区卫生服务中心合理用药的影响

Effects of the Implementation of National Essential Drug System on Rational Use of Drugs in Community Health Service Center from Shanghai City

目的:评价国家基本药物制度的实施对上海市社区卫生服务中心合理用药情况的影响。方法:随机抽取上海市城乡地区共6家样本社区卫生服务机构2010年下半年和2011年下半年每个月处方各50张,共3600张,比较不同社区卫生服务机构均次处方药品费用、均次处方药品种类、均次处方药品数量、抗菌药物处方占比、激素处方占比和注射剂处方占比的差异。结果:国家基本药物制度实施后,各项指标值均有所下降,其中城市样本机构均次处方药品数量,农村样本机构均次处方药品费用、均次处方药品数量、抗菌药物处方占比和注射剂处方占比的下降与国家基本药物制度实施前比较,差异均有统计学意义(P<0.05)。结论:国家基本药物制度对促进社区卫生服务中心合理用药有一定作用;由于上海城市社区卫生服务中心在国家基本药物制度实施前合理用药水平已经较好,因此国家基本药物制度实施对促进农村社区卫生服务中心的合理用药作用更为显著。

OBJECTIVE：To evaluate the effect of the implementation of national essential drug system on rational use of drugs in community health service centers from Shanghai area.METHODS：50 prescriptions had been randomly sampled every month from 6 sampling institutions during last six months of 2010 and 2011.A total of 3 600 prescriptions were collected.6 indicators had been calculated and compared,such as drug cost per prescription,drug types per prescription,amount of drugs per prescription,percentage of antibiotics,percentage of hormone and percentage of injection.RESULTS：The value of 6 indicators decreased after the implementation of national essential drug system;amount of drugs per prescription in urban sampling institutions,drug cost per prescription,amount of drug per prescription,percentage of antibiotics and percentage of injection in rural sampling institutions were all decreased;there were statistical significances（P0.05）,compared with before the implementation of the system.CONCLUSION：National essential drug system plays a role in rational use of drugs in community health service centers;the implementation of national essential drug system mainly promote rational drug use of rural community health service centers,because drug use of urban centers is already reasonable before that.