社区卫生服务机构基本药物合理用药评价的研究

Research of Evaluation of Rational Use of Essential Drugs in Community Health Service Institutions

目的:了解并评价社区卫生服务机构基本药物合理使用情况,为基层基本药物合理用药提供参考意见。方法:对社区卫生服务机构进行抽样调查,通过对处方进行抽样和对医生进行抽样问卷调查,根据医疗机构合理用药评价指标对处方基本药物使用情况进行评价,并分析可能导致不合理用药的相关因素。结果:单张处方平均使用药品数为:城区(4.9±1.2)个,农村(2.3±0.7)个;每100张处方抗生素使用比例:城区78.9%,农村57.3%,其中两联使用比例分别为20.1%和32.4%;人均药费:城区为(36.9±5.2)元,农村为(21.3±4.7)元;参加合理用药培训的医生所开处方药品合理使用的比率是98.0%,而未参加过培训的医生合理用药的比率是77.1%,经卡方检验,差异有统计学意义,P<0.05。结论:社区卫生服务机构存在一定的基本药物使用不合理现象,对医生加强基本药物合理使用的培训可以提高基本药物合理使用率。

Objective： To understand and evaluate the rational use of basic drugs situation in community health service institu- tions, and provide advice for rational use of essential drugs at the community. Methods： we had investigated the community health service agencies about the descriptions by sampling and the doctors by questionnaire. According to the evaluation system, we evaluated the usage of basic medicine and analyzed the related factors which may lead to unreasonable drug use. Results： Single prescription number average use of the drug is： （4.9 ＋ 1.2） in urban areas, （2.3 ＋ 0.7） in rural areas, antibiotic use of every 100 prescription： 78.9% in urban areas, 57.3% in rural areas, including two couplet use proportion were 20.1% and 32.4% respectively. Medicines per capital： （36.9＋5.2） yuan in urban area, （21.3 ＋ 4.7） yuan in rural areas. The rational drug use in training doctors was 98.0%, and the rational drug use ratio in not trained doctor was 77.1%, and the difference was statistically significant according to the chi-square test, P〈0.05. Conclusion： Community health service institutions has the phenomenon of unreasonable drug use, we can improve the reasonable utilization of essential drugs by training doctors for reasonable use of essential medicines.