老年人对基本药物政策属性认知与评价

Cognition and evaluation on policy attribute of essential drug system among community elderly

目的 了解山东省≥60岁老年人对基本药物政策属性的认知与评价,为基本药物政策制定与优化提供依据。方法 采用多阶段分层随机抽样方法,从山东省5个市抽取1 518户居民进行面访问卷调查,其中,435名≥60岁老年人。结果 老年人基本药物政策知晓率为31.3%,其中城市老年人政策知晓率（44.8%）高于农村（25.8%）;高中及以上文化程度组（61.9%）、参与城镇职工基本医疗保险组（59.4%）、以退休金为主要收入来源组（47.5%）、家庭月均收入1 001-2 000元组（41.9%）老年人政策知晓率均高于其他组（P〈0.05）;基本药物政策自然属性中的价格得分偏低,为（2.77±0.96）分,对基本药物质量不满意的比例占59.6%;政策社会属性评价中有75.0%认为患者政策受益最大,64.0%对基本药物政策总体满意,但对药店（25.6%）与村卫生室（14.7%）的健康发展持担忧态度;老年人认为现阶段政策属性急需优化的3个关键要素是基本药物目录品种、医疗机构药房基本药物配备和医生使用基本药物的意愿。结论 老年人对基本药物政策的社会属性评价较好,自然属性是现阶段基本药物政策尚需完善的重点。

Objective To examine the cognition and evaluation on policy attribute of essential drug （ED） system among community elderly and to provide a basis for the improvement of ED system. Methods Using multistage strati- fied random sampling,435 residents aged 60 years and older were selected from communities in 5 cities of Shandong province and investigated with a questionnaire. The data were analyzed with SPSS 19.0. Results The knowledge rate of ED policy among the elderly was 31.3% ,and the rate was 61.9% for the elderly with education of high school or higher and 59. 0% for those with urban employee＇ s basic medical insurance. There were significant differences in the knowledge rate of ED system among the elderly of different characteristics, with a higher rate among urban elderly than the rural elderly（44. 8% vs. 25.8% ） and a higher rate（41.9% ） among the elderly with the familial monthly income of 1 001 - 2 000 RMB Yuan than the elderly with the high or low familial monthly income （ P 〈 0. 05 ）. The score for price domain of natural policy attribute of ED system was low （2. 77 ± 0. 96）, while for the social policy attribute of ED system, 75.0% of the elderly considered the patients having the most benefit of the system. Although 64. 0% of the elderly were satisfied with ED policy,25.6% and 14. 7% of the elderly worried about the development of pharmacies and village clinics. The elderly considered insufficient list of ED, availability of ED in medical institutions, and the willingness of prescri- bing ED of the doctors as three key aspects needed to be improved for the ED system. Conclusion The community eld- erly have a good evaluation on social policy attribute of the ED system, suggesting the natural attribute of the ED system should be improved at present time.