天津市药品“零差率”政策对患者用药行为的影响研究

Studying on the influence of the policy of“Drug Without Added Profit”on patients' behavior of medicine-taking in Tianjin

目的:通过了解天津市药品"零差率"政策颁布和实施情况,发现其对患者用药行为可能产生的影响。方法:采用随机抽样的方法,以天津中医药大学第一附属医院、保康医院为依托,针对患者发放问卷550份,同时对患者、医院医生进行深度访谈,利用SPSS17.0进行数据录入与逻辑回归分析。结果:患者了解"零差率"政策程度(P=0.006<0.05)、社区医院看病与大医院报销比例的差距(P=0.007<0.05)与是否去社区医院获取医保药品均有统计学意义;大部分人购买药品时仍根据自身需要出发;在社区药品获取情况(P=0.007<0.05)、"零差率"政策是否让患者受益(P=0.010<0.05)与患者选择药物品种方面均有统计学意义;政策设计执行过程中暴露出的问题。结论:通过增加政策的宣传力度和途径以及政府政策制度和财政支持,引导患者规范自身用药行为。

Objective To study the implementation of the policy of＂Drug Without Added Profit＂in Tianjin,and explore its influence on patients＇ behavior of medicine-taking.Methods 550 cases of patients were randomly sampled from hospitals and surveyed with questionnaire.And patients and doctors were surveyed with depth interview.Data was analyzed with software of SPSS17.0.Results The patients＇ behavior of drug-using in community health centers was significantly related with their cognition on the policy of＂Drug Without Added Profit＂,and the gap of reimbursement rate between community health centers and general hospitals.There still had some problems in the implementation of the policy.Conclusion It is suggested to strengthen policy publicity,support from the government policy and finance to guide patients＇ behaviors.