基于专题小组访谈法对广州市实施国家基本药物制度情况的调查研究

Investigation and Study on the Implementation of National Essential Medicine System Based on the Method of Focus Group Discussion in Guangzhou

目的:了解广州市国家基本药物制度的实施现状以及基本药物采购过程中存在的问题。方法:采用专题小组访谈法。从广州市选取7家社区卫生服务中心和5家乡镇卫生医院作为访谈机构,每次访谈由广州市卫生局有关人员主持,由各基层医疗卫生机构的管理人员、临床医师、药品采购人员组成访谈小组,共访谈7次。对访谈结果进行归纳整理。结果与结论:国家基本药物制度实施后,医疗费用有所降低,部分药品价格有所下降,但"小病进社区,大病进医院"尚未完全实现,基本药物采购困难现象普遍存在,"缺货""断供"现象时有发生,中标厂家更换过于频繁,建立"医联体"还面临诸多问题。建议完善电子交易平台,健全基本药物供应保障体系;完善药品招标体系和监督管理机制;加强宣传教育,改善患者就医习惯。

OBJECTIVE： To study the current situation of implementation of national essential medicine system and the prob- lems of essential drugs in the procurement process in Guangzhou. METHODS：The method of focus group discussion was adopted. Total of 7 community health service centers and 5 town health hospitals were selected as the interview mechanisms in Guangzhou. Participants included the staffs from Health Bureau of Ouangzhou Municipality and managers, clinicians, buyers of pharmaceuticals from primary medical institutions. It was interviewed for 7 times. Finally the interview results were collected and analyzed. RE- SULTS ＆ CONCLUSIONS ： After the implementation of national essential medicine system, the price of drugs and health care was reduced, but “minor illness in the community, serious in the hospital” was not fully realized. There were common difficulties in the procurement of essential drugs with the phenomenon of “out of stock” and “outage”. It is too frequent about the replacement of listed manufacturers, and there remained to be many problems for the establishment of “medical conjoined”. It is suggested to im- prove the drug trading platform, the basic drug supply system and drug tender system and supervision mechanism; and to strength- en publicity and education to improve the medical treatment of patient habits.