乡村医生对实施基本药物制度支持度的影响因素分析

Analysis of influence factors for rural doctors to embrace the essential medicine system

目的：分析乡村医生对实施基本药物制度的支持度，探讨其主要影响因素及作用机制。方法分层随机抽取山东省5市621名乡村医生进行定量问卷调查，构建乡村医生政策支持度假设模型，并采用因子分析、路径分析等方法进行验证。结果59.1%的乡村医生支持基本药物制度的实施，而基本药物因子、对执行者影响因子和配套政策因子，对乡村医生的政策支持有直接影响，效应分别是0.305、0.159、0.135；基本药物因子和配套政策因子通过对执行者影响因子，对乡村医生的政策支持产生间接影响，效应分别是0.065和0.032。结论在基本药物制度推行过程中，需重视基本药物的质量、目录及价格等自身的合理性；加强政府在基本药物采购供应中的监督管理，制定合理的基本药物补助额度和补助方式，满足乡村医生的利益诉求，促进基本药物制度的推行，保证村卫生室的运行与发展。

Objective To analyze the policy support of rural doctors for the essential medicine system,and explore the main influence factors and mechanism affecting the support degree.Methods 621 rural doctors from five cities in Shandong province were subject to a stratified random sampling for a quantitative questionnaire,to build a hypothesis model of policy support of rural doctors,which is verified using factor analysis and path analysis.Results 59.1% of rural doctors support the essential drugs policy.It was found that the essential medicine factor,the factor to influence the practitioner,and the supporting policy factor had a direct impact on policy support of rural doctors,with the effect of 0.305, 0.1 59 and 0.135 respectively;Essential medicine factor and the supporting policy factor indirectly influence the policy support of rural doctors through the factor to influence practitioners,with the effect of 0.065 and 0.032 respectively.Conclusion The essential medicine system needs to emphasize such rationality as the quality,list and pricing of essential medicines;it is imperative for the government to better oversee the purchase and supply of essential drugs,to cater to the interests of rural doctors,to encourage the enforcement of the system,and promote the development of village clinics.