实施国家基本药物制度对四川省不同等级综合医疗卫生机构循环系统药物使用的影响

Influence of the Implementation of National Essential Medicine System on the Use of Cardiovascular Agents in Medical Institutions at Different Levels of Sichuan Province

目的:为促进国家基本药物制度的实施,提高循环系统药物临床合理应用水平提供参考。方法:抽取四川省21个地、市、州的58家三级、二级及以下不同等级的综合医疗卫生机构作为样本机构,从四川省非基层医疗机构药品采购、配送、监督平台数据库提取其药品采购数据,对国家基本药物制度实施前、后样本机构的循环系统药物中基本药物的采购品种及金额情况进行统计分析。结果:国家基本药物制度实施后,不同等级的综合医疗卫生机构循环系统药物中基本药物的采购品种及金额均呈现明显增长态势;二级及以下医疗卫生机构循环系统药物中基本药物品种占比及其在全部药品中的占比甚至超过了非基本药物;但其金额占比却远不及非基本药物;医疗卫生机构等级越高,其基本药物金额占比越低,明显低于非基本药物。结论:国家基本药物制度实施虽然对综合医疗卫生机构循环系统药物的使用产生了积极影响,但由于患者疾病、目录收载品种及价格等诸多因素的影响,其在医疗卫生机构尤其是三级医疗卫生机构的占比很难提升。

OBJECTIVE： To provide reference for the implementation of essential medicine system and rational use of cardio- vascular agents. METHODS： 58 medical institutions with third grade, second grade or below from 21 different regions of Sichuan province were extracted as sample in which their data were collected from the monitoring platform database of drug procurement and delivery for non-grassroots medical institutions in Sichuan province; the types and amounts of essential medicines among cardio- vascular agents in sample institutions were analyzed statistically before and after the implementation of national essential medicine system. RESULTS ： After the implementation of national essential medicine system, the varieties and amount of essential medicines among cardiovascular agents were increased greatly in different grade medical institutions; the proportion of essential medicines in cardiovascular agents and their proportion in the total amount of medicines exceeded the corresponding proportion of non-essential medicines in second grade or below medical institutions; the proportion of amount of essential medicines was far less than that of non-essential medicines. The higher the grade of medical institution was, the lower the proportion of amount of essential drugs was; it was significantly lower than that of non-essential medicines. CONCLUSIONS： The implementation of national essential medicine system shows a positive impact on the use of cardiovascular agents in comprehensive medical institutions; due to the pa- tient＇ s disease, species selection of the list and medicine price, the proportion of the amount of cardiovascular agents in total amount of medicine is difficult to raise in medical institutions, especially in third grade general medical institutions.