乡镇卫生院基本药物政策执行困难原因调查

Investigations on causes of implementation difficulty of the essential drugs policy at township health centers

目的 探讨在乡镇卫生院管理者视角下,基本药物制度执行情况及政策执行困难的成因,并提出优化策略.方法 对山东省某市18所乡镇卫生院的21位管理者进行间卷调查及深入访谈,分析基本药物制度在乡镇卫生院的执行情况以及政策推行过程中遇到的困难等.结果 19位管理者了解基本药物制度,但5位管理者认为政策的实施影响了乡镇卫生院的发展,尤其是特色专科服务的开展;同时认为存在政府投入不足、基本药物的供应配送不及时且缺乏药品供应系统的信息反馈等问题.结论 合理设计并动态调整基本药物目录,加大财政投入,规范药品的招标采购,健全信息反馈机制,采取措施促进综合能力强或有特色专科医院的可持续发展,提高管理者的政策认知和认同,可保证政策的有效执行.

Objective The paper probed into the causes of implementation difficulty of the essential drugs system and the policy as viewed by township health center managers,and proposed optimization strategies.Methods Questionnaire survey and interviews on 21 managers of 18 township health centers in a city in Shandong,and analysis of the implementation of the essential drugs system at such centers and roadblocks encountered.Results 19 of the managers understand the policy,yet five of them hold that such a policy delays their development,especially their characteristic specialties.They also complained on insufficient government investment,delayed supply of essential drugs and lack of feedback in medicine supplying system.Conclusion Recommendations include reasonable design and dynamic adjustment of the essential drugs list,greater government investments,standardized drugs bidding and procurement mechanism,and better information feedback mechanism.The government is also proposed to encourage the development of those centers with high capacity in general or those with specialized services,and to improve the policy awareness and recognition of the managers to ensure effective implementation of the policy.