北京市西城区社区卫生服务机构实施基本药物制度的效果评价与思考

Effect Evaluation and Consideration of Essential Drug System in Beijing Xicheng District around 6 Years before and after the Implementation of the System

目的:为促进基本药物制度的深入实施提供参考。方法:采用描述性分析法,统计北京市西城区社区卫生服务机构实施基本药物制度前后的门急诊量、业务收入、政府财政补助、基本药物销售占比及平均门诊费用等数据,对制度实施效果及其对基层医疗卫生机构的影响进行评价。结果:2006-2011年,西城区社区卫生服务机构的财政补助收入从0.16亿元增至4.84亿元;业务总收入、医疗收入和药品收入逐年增长,年均增长率分别为44.12%、29.55%和47.28%;基本药物销售占比变化平稳,浮动于50%～56%之间;门诊服务量逐年递增,年均增长率达29.79%;门诊次均费用和单处方费用2007年与2006年相比,分别下降了33.94%和29.97%。结论:实施基本药物制度后,财政补助力度加大,社区卫生服务机构门诊服务量和业务收入双增长,但基本药物销售占比没有呈现增长趋势。建议进一步加大对基本药物制度的宣传力度,提高公众对基本药物的认知度;调整支持政策,促进社区卫生服务机构的可持续发展。

OBJECTIVE：To provide reference for the implementation of essential drug system.METHODS：By descriptive analysis method,outpatient emergency services,business income,the proportion of essential drug sales and average outpatient expenses in community health services institutions of a district in Beijing were analyzed before and after the implementation of essential drug system to evaluate the effect of the system and the impact of it on primary medical institution.RESULTS：From 20062011,Financial assistance increased to 484 million yuan from 16 million yuan;the total income,medical income and drug income increased year by year,with annual growth rate of 44.12%,29.55% and 47.28%;the proportion of essential drug sales changed smoothly,floating between 50%-56%;the number of outpatient services had increased year by year,with annual growth rate of 29.79%;In 2007,outpatient costs per time and prescription costs fell by 33.94% and 29.97%,compared with 2006.CONCLUSION：After the implementation of essential drug system,financial benefits have increased,and the number of outpatient services and total income both have grew,but the proportion of essential drug sales shows no growth trend.So it is suggested to do further strengthen propaganda,raise public awareness of essential drugs;adjust the support policy,and promote the sustainable development of community health care institutions.