上海市公立三级综合医院医药分开试点对门急诊用药行为的影响

Effects of separating drug sales from medical services on the prescribing behavior among outpatients and emergency services in the general tertiary public hospitals of Shanghai

目的:分析和评估医药分开政策对公立三级综合医院医生门急诊用药行为的影响。方法:从医保角度,对4家试点医院和3家对照医院的医生门急诊用药行为进行对比分析。结果:平均每张处方用药品种数、注射剂使用率、基本药物使用率差异不明显,抗菌药使用率试点医院明显低于对照医院;平均每张处方药品费用试点医院高于对照医院,但是处方率试点医院低于对照医院。结论:医药分开政策尚未对医生的用药行为产生明显影响;从医生及患者的用药习惯、药品供销的利益链及医药分开试行范围分析可知,促进医生合理用药仍需综合多方措施。

Objective： To analyze and evaluate the effects of separating drug sales from medical services on the prescribing behaviors among outpatient and emergency services in the general tertiary public hospitals. Methods：From the perspective of medical insurance,the above mentioned prescribing behaviors were analyzed between four pilot hospitals and three control hospitals. Results： There was no obvious difference in the average number of drugs per prescription,the rate of injection usage,and the rate of essential drugs utilization. The antibiotic usage was higher in the pilot hospitals than in control ones,but the average cost per prescription was significantly lower in pilot hospitals than in control hospitals. Conclusion： From the analysis of data,the ＂separating drug sales from medical services＂policies had no significant impact on the prescribing behavior. After analyzing the drug use habits of doctors and patients and the pharmaceutical supply and marketing interest chain,more comprehensive multi-measures are needed to promote rational drug use.