江苏省农村地区实施基本药物制度前后用药情况分析

Drug Use Before and After the Implementation of Essential Drug System in the Rural Areas of Jiangsu Province

目的探讨江苏省农村地区实施基本药物制度前后用药变化情况。方法收集2010、2011年江苏省部分地区12家乡镇卫生院的处方数据进行基本药物销售额分析,抽查2010年10月、2011年10月门诊处方各100张进行合理用药分析,发放问卷随机调查农村居民药品费用支出变化情况。结果基本药物制度实施后,基本药物销售金额占药品销售总金额比例平均从2010年的32.58%上升到2011年的52.92%;基本药物处方比例同比增加43.94%,平均每张处方药费同比下降23.52%。24.04%(75/312)的农村居民认为基本药物制度实施后,就诊费用支出基本不变;39.42%(123/312)则认为就诊费用小幅降低,实惠不明显;16.03%(50/312)认为就诊费用反而增加;11.22%(35/312)认为就诊费用大幅降低,实惠明显。结论实施基本药物制度后,乡镇卫生院收支结构发生改变,患者就医负担有所减轻,但不合理用药情况依然存在。

Objective To assess the changes in drug use after the implementation of essential medicine system in the rural areas of Jiangsu Province. Methods We collected prescription data from 12 rural health centers in Jiangsu Province of 2010 and 2011 and made an analysis of the sales volume of essential medicines. We randomly selected 100 prescriptions of October 2010 and 100 prescriptions of October 2011 for the analysis of rational drug use. Random questionnaire survey was conducted to investigate the changes of rural residents＇ expenses on medicines. Results After the implementation of essential drug system,the ratio of the sales amount of essential medicines to the aggregate medicine sales amount increased from 32. 58% in 2010 to 52. 92%in 2011; the proportion of essential medicine prescription increased by 43. 94% compared with the same period of last year,and the average medicine expense of each prescription dropped to 23. 52% compared with the same period of last year. Among the rural residents who were investigated,24. 04%（ 75 /312） thought the medical expenses basically remained unchanged after the implementation of essential drug system,39. 42%（ 123 /312） thought the medical expenses decreased slightly with unobvious benefits,16. 03%（ 50 /312） thought the medical expenses increased instead, and 11. 22%（ 35 /312） thought the medical expenses decreased significantly. Conclusion After the implementation of essential drugs system,the revenue and expenditure structure of rural health centers has changed,and patients＇ financial burden has been eased,while the irrational drug use still exists.