实施国家基本药物制度对某三级医院药品费用的影响

Impact of Implementing National Essential Drug System on Drug Expenses in a Hospital

目的了解国家基本药物制度的实施对医院药品费用和用药结构的影响。方法调查并对比分析国家基本药物制度实施前后医院患者的次均就医费用、次均药品费用、药占比、自付比例等数据。结果与国家基本药物制度实施前比较,医院门诊和住院次均就医费用分别下降了5.86%和5.39%,次均药品费用分别下降了6.32%和6.93%,差异均有统计学意义(P<0.05);药占比分别下降了0.56%和0.73%,差异无统计学意义(P>0.05);患者总体个人自付比例分别下降了1.76%和1.69%,药品自付比例分别下降了1.72%和1.84%,差异均有统计学意义(P<0.05),且廉价药品销售额占比明显上升(P<0.05),但医院基本药物的使用量未明显增加。结论国家基本药物制度的实施有效控制了药品费用,缓解了"看病贵"的状况;但基本药物在该院未得到广泛应用,建议加强对国家基本药物的宣传和医院管理与考核,规范医务人员处方行为,促进合理用药。

Objective To investigate the effect of the implementation of the national essential drug system on the drug expense and structure of drug use in the hospital. Methods The data of average medical expense per patient,average drug expense per patients, drug proportion and individual self-paid ratio before and after the implementation of the national essential drug system were investigat-ed and performed the comparative analysis. Results Compared with before the implementation of the national essential drug system,the average medical expense per outpatient and inpatient was dropped by 5. 86% and 5. 39% respectively,the average drug expense per outpatient and inpatient was dropped by 6. 32% and 6. 93% respectively,the difference between before and after treatment was statisti-cally significant （ P ﹤ 0. 05 ） . The drug proportion of outpatient and inpatient was dropped by 0. 56% and 0. 73% respectively,but the diffenence between before and after treatment had no statistical significance;the total individual self-paid ratio per outpatient and inpa-tient was dropped by 1. 76% and 1. 69% respectively,the drug individual self-paid ratio per outpatient and inpatient was dropped by 1. 72% and 1. 84% respectively,the difference between before and after treatment was statistically significant （ P ﹤ 0. 05 ） ,and the con-stituent ratio of cheap drugs sales amount accounting for the whole drugs sales amount was significantly increased （ P ﹤ 0. 05 ） . But the use amount of essential drugs had no obvious increase. Conclusion The implementation of the national essential drug system effectively controls the drug expense and relieves the situation of“high cost of getting medical service”;but the essential drugs have not been used widely in the hospital. It is suggested to strengthen the promotion of the essential drugs as well as the hospital management and assessment,and standardize the prescription behavior of medical staff for promoting rational drug use.