农村居民对村卫生室基本药物制度评价研究——基于甘肃、湖北、浙江三省调查数据

Survey on rural residents' evaluation of the national essential medicine system in village clinics:Based on survey data from Gansu,Hubei and Zhejiang

目的:了解基本药物制度实施后我国不同地区农村居民对村卫生室基本药物制度实施情况的评价,分析影响因素,为推进村卫生室基本药物制度的实施提供建议。方法:运用多阶段随机抽样,对甘肃省(西部)、湖北省(中部)、浙江省(东部)三省5个市(县)20个乡(镇)的2 769名乡村居民进行问卷调查。结果:受访者听说过"基本药物制度"和"零差率"销售的比例分别为23.69%、16.50%。受访者在村卫生室接受过"基本药物制度"宣传比例为16.07%,认为当前村卫生室药物能满足基本需求的占65.47%;认为基本药物零差率实施后看病费用未下降的占68.12%。根据Likert量表,村民对村卫生室药品服务总体满意度得分为74.90分。logistic回归分析结果显示:农村居民对村卫生室药品服务满意度的影响因素主要有地区因素、看病费用变化情况、药物满足村民治疗需求情况、药品品质、药品价格、药品效果、药品品种和村医服务态度。结论:大多数农村居民对基本药物制度持正面评价,对村卫生室提供的药品服务整体上比较满意,但基本药物并不能完全满足群众需求。应进一步发挥村卫生室在基本药物制度宣传中的作用,提高农村居民对基本药物的认知度。同时,完善基本药物目录,满足农村居民用药需求。

Objective： To investigate the evaluation of rural residents for the implementation of the national essential medicine system in village clinics, and to analyze the influencing factors. Our findings will provide the feasibility advice for the improvement of the national essential medicine system in rural areas. Methods ： A self-made questionnaire was used to collect data. we select 2 769 rural residents in five counties, all from 20 township hospitals within three provinces by survey. Results： 23.69% of respondents have heard of national essential medicine system and 16. 50% of respondents have gained understanding of drug ＂zero profit＂ sales, 16.07% of respondents have received the publicity of national essential medicine system in the village clinics; 65.47% of the respondents considered that the drugs in village clinics can meet the basic needs of masses. However, 68. 12% of rural residents confirmed the implementation of ＇ Zero-Mark-up Policy for Essential Medicines＇ did not cut down medical care costs. The overall satisfaction score for the pharmaceutical services was 74. 90 based on the Likert＇s scale. Logistic regression analysis shows that： service are mainly local factors, medical care spending, points, which indicated a ＇moderate satisfaction＇ factors of villagers＇ satisfaction for pharmaceutical drugs to meet the needs of the villagers, the drug quality, drug prices, drug efficacy, drug varieties, the service attitude of rural doctor. Conclusions： Most of the rural residents hold a positive attitude to the national essential medicine system. In general, pharmaceutical services provided to the village clinic is quite satisfactory, but the basic drugs do not fully meet the needs of the masses. The role of the village clinics in the system for basic drugs propaganda should be played further to enhance the villagers awareness of basic drugs. At the same time, the national essential medicine system directory should be improved so as to adapt themselves to the demands the villagers medication.