城市社区卫生服务机构基本药物制度实施实证分析

Empirical analysis on implementation of essential drug system in community health service institutions

[目的]探讨基本药物制度实施下,城市社区卫生服务机构的相关行为,为促进制度可持续发展提供政策依据。[方法]运用现场调研、问卷调查法分析社区卫生服务机构的经济运行情况和合理用药情况。[结果]社区卫生服务机构2009-2011年的次均门诊费用、次均住院费用、药品占门诊费用和住院费用比例呈逐年下降趋势,2012年有所上升;机构的收支结余在2009-2011年出现下降后在2012年有了上升。平均每张处方用药2.11种,口服药使用率为70.04%,抗菌药使用率为24.19%,中成药20.22%,注射剂使用率26.59%,处方合理用药行为有所改善。[结论]社区卫生服务机构的经济运行情况受到基本药物制度影响,为促进基本药物制度长效、稳定发展,应以政府为主导,加强激励和监管;弥补社区卫生服务机构收支差额。

Objective This paper discusses the relevance of community health service institutions under the implementation of essential drug system so as to provide policy basis for promoting sustainable development. Methods Using field investigation and questionnaire survey to analyze economic operation and rational drug use situation. Results From 2009 to 2011,the ratio of outpatient,hospitalization and drug frequency expenses up outpatient and hospitalization expenses was downswing year by year. But it went up in 2012,so as well as the balance of financial revenue and expenditure. The drug use was 2. 11 per prescription. Oral medicine usage rate was 70. 04%,antibacterial was 24. 19%,Chinese patent medicine was 20. 22%,and injection was 26. 59%. The behaviour of prescription rational drug use had improved. Conclusions The economic operation of community health service institutions is affected by essential drug system. It should take government as leader,strengthen incentive and supervision,make up the community health service institutions＇ finance balance for promoting essential drug system long-acting and stable development.