江苏省海门市乡镇卫生院实施基本药物制度前后的监测评价分析

Effects of the Implementation of National Essential Medicine System in Township Hospitals in Haimen,Jiangsu

目的:了解江苏省海门市乡镇卫生院实施国家基本药物制度后的现状,监测评价海门市乡镇卫生院实施国家基本药物制度前后的情况。方法:收集2010-2012年海门市所有乡镇卫生院的财务数据进行对比分析,随机抽取6个乡镇卫生院的门诊处方进行合理用药研究。结果:实施基本药物制度后,平均每家乡镇卫生院的财政补助收入大幅上升,2011年达到154.79万元,2012年上升了161.4%,达404.63万元。药品收入有所下降,但药占比水平仍较高,达62%。基本药物制度实施后,每张处方平均费用下降了17.21%。每张处方平均用药品种数从2.34下降为2.16。抗菌药物使用率从52.70%下降到46.00%,激素使用率从8.00%下降到5.70%,不合格处方率从29.30%下降到17.83%,输液治疗率从16.70%上升到26.50%。结论:实施基本药物制度后,乡镇卫生院诊疗人次逐年上升,患者就医负担有所减轻,收支结构发生改变,不合理用药情况依然严峻。

Objective：Learn about the status of township hospitals after the implementation of National Essential Medicine System in Haimen. Methods： Comparatively analyze the financial data collected in 2010 -2012. Six township hospitals outpatient prescription for rational drug use analysis. Results： After the implementation of the National Essential Medicine System, the financial subsidies income of average each township hospitals reached 1. 5479 million Yuan in 2011, and increased by 161.4%, reached 4. 0463 million Yuan in 2012. The drug income declined,the level of the drug proportion of the operating income is still high, more than 62%. The average cost of each prescription went down by 17.21% ,the average number of drug varieties per prescription went down from 2.34 to 2.16, the Antimicrubialusage went down from 52.70% to 42.00%, Hormone usage went down from 8.00% to 5.70% and Failure prescription rates went down from 29.30% to 17.83%. Infusion therapy rate increased from 16.70% to 26.5%. Conclusion： After the implementation of the National Essential Medicine System, the outpatient visits increased year by year, the burden of patient has been lightened, the expenditure structure has been changed, irrational drug situation remains grim.