某省不同等级医疗机构基于采购价格的基本药物种类构成比较

Different Levels of Medical Institutions in A Provincial Sort Structure Comparison Based on the Purchasing Prices of Essential Drugs

目的比较贵州省各级医疗机构（如省级、市（州）级、县级、民营、乡镇、社区）之间基于采购价格的各种基本药物种类构成的差异,为基本药物的采购提供数据依据,进而为降低医药费用提供合理建议。方法采用多阶段分层简单随机抽样和简单抽样的抽样方法抽取研究对象,用χ-2检验对构成比进行比较,用秩和检验对各级医疗机构基本药物的价格构成进行比较。结果贵州省各级医疗机构基于采购价格的种类总体构成比不同,P〈0.05,差异有统计学意义;贵州省各级医疗机构之间基于采购价格的基本药物种类构成不同,P〈0.05,差异有统计学意义;同一级别的医疗机构之间基于采购价格的基本药物种类小部分不一致,P〈0.05,差异有统计学意义;大部分一致,P〉0.05,差异不具有统计学意义。不同等级医疗机构之间基于采购价格的基本药物种类不同,P〈0.05,差异有统计学意义。结论贵州省各级医疗机构基于采购价格的种类总体构成比不同。贵州省同一级别的医疗机构之间基于采购价格基本药物种类构成小部分不一致,大部分一致。不同等级医疗机构之间基于采购价格基本药物种类构成不同,级别越高的医疗机构（如省医、遵医附院）基本药物种类多为高价药,基层医疗机构（如乡镇卫生院）基本药物种类多为低价药。

Objective Comparison all levels of medical institutions, such as the provincial level, municipalities（state）, county, private, villages and towns, community） based on the purchase price between difference of various kinds of basic drugs in guizhou province, provide data basis for essential medicines procurement, to provide reasonable suggestions to reduce medical costs. Methods Using multi-stage sampling of simple random sampling and stratified cluster sampling method to extract the research object, using chi-square test form than in the comparison, with the rank and inspection to the basic medical institutions at all levels of drug price comparison. Results Between medical institutions at all levels based on purchasing price overall composition ratio is different in guizhou province, P〈0.05, the difference was statistically significant; Between medical institutions at all levels based on the purchase species prices of basic drugs composition of different procurement, P〈0.05, the difference was statistically significant in guizhou province; Between medical institutions of the same level on the base of the purchase price of drug kinds minor inconsistencies, P〈0.05, the difference was statistically significant; Most agree, P〉0.05, no statistically significant difference. Between different levels of medical institutions based on different procurement purchase prices of basic drugs, P〈0.05, the difference was statistically significant. Conclusion All levels of medical institutions based on the types of procurement purchase prices overall composition than different in guizhou province. Between medical institutions of the same level in guizhou province based on the purchase price of essential medicines constitute a small number of inconsistencies, most consistent. Between different levels of medical institutions based on the purchase price of essential medicines species composition is different, the higher the level of the medical institutions（such as Guizhou province people＇s hospital, Zunyi medical college affiliated hospital） basic drugs variety for expensive medicine, grassroots medical institutions（e.g, health clinics in towns and townships） basic drugs variety for cheap medicine.