上海市某区基本药物制度实施后的现状、问题及思考

Study on the Present Status of Essential Medication and Problems in Community Health Centers in a District of Shanghai

目的:了解基本药物制度实施后对上海市某区各级医疗机构医务人员工作及居民就医行为和满意度产生的影响。方法:采用定量和定性相结合的方法,对上海市某区各级医疗机构在基本药物制度实施后的现状、问题及医务人员与就诊居民的行为和满意度开展调查。结果:基本药物目录与基层需求存在差距,药品价格优惠不明显,部分药品质量明显下降,少数基本药物尤其是急救药品易出现缺货断货现象,二三级医院对基层医疗机构合理使用基本药物影响较大。结论:合理调整基本药物目录;完善药品招投标、质量监督、配送和流通领域监管体系;加大二、三级医疗机构优先使用基本药物的考核力度。

Objective To study the present status and impact of essential medicines application on medical personnel and pa- tients. Methods Quantitative and qualitative studies were carried out in a district of Shanghai to survey the behavior and satisfac- tion change of medical personnel and patients after the implementation of essential medicine policy. Results After the policy im- plemented in community health centers, there was little decrease of medicine price from the view of patients while the package quality of essential medicine became poorer and certain kinds of essential medicine were in short supply. Besides, doctors from grade two and grade three hospitals have fewer knowledge and usage of essential medicine than those from community health cen- ters. Conclusion Adjust essential medicine list reasonably. Perfect the purchasing, quality supervision and supply chain system of essential medicine. Take measures to encourage doctors from grade two and grade three hospitals to use essential medicine first.