基层医疗机构实施国家基本药物制度的效果评价指标体系研究

Evaluation Index System of the National Essential Medicine System in Primary Medical Settings

目的建立一套科学、可行的基层医疗机构实施国家基本药物制度的效果评价指标体系。方法采用文献研究法和德尔菲法,于2015年8月以电子邮件的方式向江苏省内19例长期从事卫生管理、医保管理和科研教学的专家发放两轮专家咨询表。通过两轮的专家咨询筛选出基层医疗机构实施国家基本药物制度的效果评价指标,并运用双维量化法和层次分析法确定出指标体系的最终权重。结果第一轮共发放咨询表19份,回收咨询表19份,经逻辑校验,有效咨询表18份,有效率为95%。第二轮共发放咨询表19份,回收咨询表19份,经逻辑校验,有效咨询表19份,有效率为100%。参考专家意见并经课题组讨论,最终确定出＂个人医药费用负担和满意度＂＂财政和医保补助＂＂基层医疗机构经营状况＂3个一级指标和相应的9个二级指标、21个三级指标,最终权重为0.006 1～0.109 7。结论建立了基层医疗机构实施国家基本药物制度的效果评价指标体系,可用于更好地监测、评估基本药物制度在基层医疗机构的运行状况。

Objective To establish a more scientific and practical evaluation index system of the national essential medicine system in primary medical settings. Methods In August 2015, using literature research method and delphi method, two rounds of expert consultation by emails were conducted on 19 experts who engaged in health management, medical insurance management, and research and teaching for a long time in Jiangsu Province. Evaluation indexes for the implementation of the national essential medicine system in primary medical settings were selected by two rounds of expert consultation, and two - dimension measure and analytic hierarchy process were used to determine the ultimate weight of the index system. Results In the first round of consultation, 19 consultation tables were sent, and all of them were returned; after logic checkout, there were 18 effective consultation tables with an effective rate of 95%. In the second round of consultation, 19 consultation tables were sent, and all of them were returned; after logic checkout, there were 19 effective consultation tables with an effective rate of 100%. After receiving experts＇ opinions and group discussion, we finally determined 3 first - level indexes which were ＂ burden and satisfaction degree of personal medical expense＂,＂ financial and medical insurance subsidy＂ and ＂ status of primary medical settings＂ , 9 second - level indexes and 21 third - level indexes. The ultimate weight was 0. 006 1 - 0. 109 7. Conclusion The evaluation index system can provide a reference to better monitor and assess the status of national essential medicine system in primary medical settings.