我国基本药物制度实施效果的文献研究与评价

Literature review and comments on implementation outcomes of the essential medicine system in China

目的全面系统地描述我国基本药物制度实施的效果或影响，为完善基本药物制度提供科学证据。方法采用系统评价的方法对基本药物制度实施效果研究的文献提取信息、分析和描述信息。结果共纳入87篇文献，研究对象以基层医疗机构为主，以居民或患者为对象的研究有4篇、医药企业1篇。医疗机构基本药物配备率趋于上升，医疗费用下降，业务量升降不一，患者明显感到了药品价格下降，促进了合理用药。现有证据表明基本药物制度实施后已经出现了一些预想的效果。结论目前针对我国基本药物制度的研究以基层医疗机构、经济发达地区为主，现有的研究欠缺严谨的设计。建议对基本药物制度实施情况开展更广范围、更深层次、设计严格的研究，以评价制度对不同政策相关者造成的影响和实施效果。

Objective A systematic review of implementation outcomes of the essential medicine system in China to identify scientific evidences for a better system. Methods A systematic review is made to extract data from the research papers on outcomes of the essential medicine system, followed by an analysis and description of such data. Results Of the 87 papers included, most of them focused on primary care institutions, while four of them on residents or patients, and one of them on pharmaceutical enterprises. The study found the medical institutions with rising availability of essential drugs, lowered medicine costs, rising or dropping business volume, and apparent drop of out-of-pocket expenses for patients. These have encouraged rational drug use. Evidences in hand indicate expected outcomes from the essential medicine system. Conclusion Current researches on the system focus on primary care institutions in developed areas in China, lacking rigorous design. Studies of broader scale, further depth and more rigorous designs of the implementations of the system are recommended for evaluation of the impacts and outcomes of the system on various stakeholders of the policy.