国家基本药物制度下陕西省乡镇卫生院门诊处方调研

Investigation and Survey of Outpatient Prescriptions in the Township Hospitals of Shaanxi Province under National Essential Drug System

目的:了解国家基本药物制度实施前、后陕西省乡镇卫生院门诊处方状况及其对处方费用的影响,为完善国家基本药物制度提供参考。方法:采用多阶段随机抽样法抽取陕西省样本乡镇卫生院的门诊处方,进行定量分析,同时对医务人员进行国家基本药物制度的定性访谈。结果:国家基本药物制度提高了乡镇卫生院基本药物使用率,一定程度上降低了门诊处方费用,但由于药品"零差率"销售导致乡镇卫生院收入锐减,加之财政补偿不足、到位不及时问题导致乡镇卫生院的抗菌药物、注射剂和激素使用率过高。结论:政府需继续大力实施国家基本药物制度,积极落实财政补偿政策,提高乡镇卫生院医务人员基本药物知晓率和用药科学性,培养农村居民用药安全意识。

OBJECTIVE： To study the situation of outpatient prescription in the township hospitals of Shaanxi province before and after the implementation of national essential drug system and to analyze the influential factors so as to put forward suggestion and countermeasures. METHODS： By multi-stage random sampling, outpatient prescriptions were collected from township hospi- tals and analyzed quantitatively; interviews were conducted among medical staffs about their opinions of the national essential drug system. RESULTS： The national essential drug system had improved the utilization ratio of essential drug and reduced outpatient prescription costs to a certain extent. However, the income of township hospitals decreased sharply because of zero-profit drug sales, and utilization ratio of antibiotics, injections and hormones were quite high due to insufficient and inefficient fiscal invest- ment. CONCLUSION： To advocate the national essential drug system confirmedly and implement the fiscal compensation policy ac- tively improves scientific drug use and awareness of medical staffs to essential drug and develops awareness of farmer to drug safe- tv.